Tarsal Coalitions

Tarsal coalitions are a commonly missed diagnosis. They occur when there is a failure of bones to separate properly during development and a bridge exists between them two bones in the rearfoot or tarsal bones. Initially this is usually asymptomatic as the bones are still cartilage and movement is possible. As the bones ossify, the tarsal coalition can become symptomatic in the rearfoot. Sometimes a peroneal spastic flatfoot develops as the foot tries to splint itself to protect from the pain. Two common tarsal coalitions are between the talus and calcaneus (talocalcaneal coalition) and between the calcaneus and navicular (calcaneonavicular coalition). There are really only two treatment options for a tarsal coalition. The bony bridge can be surgical removed or foot orthotic can be used to try and restrict motion and help with the symptoms. Sometimes physical therapy also helps in conjunction with the foot orthotic.

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