Tarsal Coalition

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What Is a Tarsal Coalition?

The tarsal bones are a set of bones made up of the calcaneus, talus, navicular and cuboid. Together, these bones form a joint that is important for the foot to work the way that it should. Sometimes, there is an atypical growth that is made up of bone cartilage or extra fibrous tissue that goes across these joints — that is a tarsal coalition. The tarsal coalition can affect how your child can move, causing pain and stiffness, and may make it very difficult for your child to move the foot.

What Are Signs of a Tarsal Coalition?

Many children with this condition are born with it. The signs usually start showing in kids ages 9 to 16. This is due to the fact that children’s bones are becoming mostly bone after being mostly cartilage during these age groups. The coalition usually becomes painful during that time. In addition to pain, other signs may include:

  • Flat feet or a flat foot (some children with flat feet experience this, not all)
  • Limping
  • Stiffness in the foot
  • Muscle spasms

Treatment

Nonsurgical Treatments

These treatments can help lessen pain and the number of muscle spasms a child may have:

  • Anti-inflammatory medicines
  • Casts or walking boots
  • Injections, such as anesthetics and steroids for pain relief
  • Custom shoe inserts that support affected joints
  • Stretching and physical therapy

Surgical Options

If you child continues to have pain after treatment, your doctor may consider surgery. The type of surgery depends on your child’s coalition type, whether there is arthritis in the foot and if so, how widespread it is.

A splint or cast is placed after surgery, along with crutches to keep weight off of the foot and keep it in place. Exercises to rebuild muscle tone and range of motion can start about one to two weeks after surgery. Walking begins about one month after surgery.

Follow-Up

Children who are treated for this condition have a high likelihood of becoming free of pain.

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