Tarsal coalition

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A condition where two or more bones in the foot are abnormally connected.


Animation showing the tarsal bones of the foot.

Tarsal coalition is a congenital condition characterized by an abnormal connection between two or more of the tarsal bones in the foot. This connection can be composed of bone, cartilage, or fibrous tissue. Tarsal coalition can lead to restricted movement and pain in the foot, often resulting in a flatfoot deformity.

Anatomy of the Tarsal Bones

The tarsal bones are a group of seven bones located in the foot, forming the ankle and the back part of the foot arch. These bones include the talus, calcaneus, navicular, cuboid, and the three cuneiform bones. The tarsal bones play a crucial role in foot movement and stability.

Types of Tarsal Coalition

Tarsal coalitions are classified based on the bones involved and the type of tissue connecting them. The most common types are:

  • Talocalcaneal coalition: A connection between the talus and calcaneus.
  • Calcaneonavicular coalition: A connection between the calcaneus and navicular bones.

Symptoms

Symptoms of tarsal coalition can vary depending on the severity of the condition and the specific bones involved. Common symptoms include:

  • Pain in the foot, especially around the ankle.
  • Stiffness and limited range of motion in the foot.
  • Flatfoot deformity.
  • Frequent ankle sprains.

Diagnosis

Diagnosis of tarsal coalition typically involves a combination of physical examination and imaging studies. X-rays, CT scans, and MRI are commonly used to visualize the abnormal connections between the tarsal bones.

Treatment

Treatment options for tarsal coalition depend on the severity of the symptoms and the impact on the patient's quality of life. Options include:

  • Conservative treatment: Includes rest, orthotic devices, physical therapy, and anti-inflammatory medications.
  • Surgical treatment: In cases where conservative treatment is ineffective, surgery may be necessary to resect the coalition or to perform a corrective osteotomy.

Prognosis

The prognosis for individuals with tarsal coalition varies. Many people with mild coalitions may remain asymptomatic throughout their lives, while others may experience significant pain and disability. Early diagnosis and appropriate management can improve outcomes.

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