Tarsal Coalition

Tarsal Coalition

The term tarsal coalition may sound like a natural disaster or such, but the staff and physicians at Advanced Foot and Ankle Center assure you that it is not.

The word “tarsal” refers to the group of bones located in the foot just in front and below the ankle.  The bones that compromise the tarsus are the talus, calcaneus, navicular, cuboid and the three cuneiform bones.  The word “coalition” refers to a failure of a joint or joints to form.  Thus, a tarsal coalition is a failure of a joint or joints to form between the bones in the rearfoot.  One or more joints can have coalitions.  Developmentally speaking, a coalition is a failure of mesenchymal differentiation during fetal development.  With that being said, most coalitions are present at birth.  Trauma does not cause coalitions but can cause severe arthritis that can lead to joint fusion by gradual wearing away of cartilage or by a fracture through a joint.

The symptoms of a tarsal coalition typically do not present early in life.  Many times, symptoms are not seen until 9-12 years old or even later.  Some symptoms of a tarsal coalition include a fallen stiff arch, pain with walking and running, foot fatigue, awkward gait or walking pattern, or spasm and muscle cramps of the foot or lower leg.

Diagnosis can be relatively easily by examination by Dr. Silvers and Dr. Williams at Foot and Ankle Center.  During their evaluation, they will place the patients foot through range of motion, to assess the presence or absence of a joint or joints.  In addition, x-rays will be taken in the office to evaluated the bones and joints of the foot.  Since coalitions may be fibrous (soft tissue), cartilage, or bone, advanced Imaging Studies such as MRI or CT may be ordered.

Treatment

Treatment of tarsal coalitions can be broken down into surgical and non surgical treatments.  Non surgical treatment is aimed at reducing inflammation and abnormal motion in the foot.  This can be accomplished with Custom Molded Foot Orthotics, oral non steroidal anti-inflammatory drugs, cortisone injections, physical therapy and cast and/or walking boot immobilization.

Surgical treatment is only performed if conservative treatment fails.  Dr. Silvers and Dr. Williams exhaust all conservative options prior to operating on feet with tarsal coalitions.

For an appointment with Dr. Silvers or Dr. Williams, please call us at 972-542-2155.