Tarsal Coalition | Orthopaedics | Loyola Medicine

Tarsal Coalition

Overview and Facts about Tarsal Coalition

A tarsal coalition occurs when there is an abnormal connection between the bones in the back of the foot. This abnormal connection can be made of fibrous tissue, cartilage or bone, and it reduces movement and flexibility in the foot. The most common kind of tarsal coalition happens between the navicular and calcaneus bone, but connections between the talus and calcaneus bone can also occur.

It is estimated that about one in every 100 people has a tarsal coalition. While the condition can occur in one foot, around 50 percent of cases occur in both feet.

Signs and Symptoms of Tarsal Coalition

Because people are commonly born with a tarsal coalition, many children begin seeing symptoms between the ages of 9 to 16. However, some people with these orthopaedic conditions do not have symptoms until later in life. When symptoms are present, they include:

  • Pain in the foot, especially when standing or walking
  • Stiffness in the ankle and foot
  • Having a flat foot
  • Spasms in the leg that make your foot turn outward
  • Legs that feel tired
  • Limping

Causes and Risk Factors of Tarsal Coalition

Many cases of tarsal coalition occur while the fetus is developing in the womb. Some of the bones don’t grow properly, creating the abnormal connection. Scientists believe there is a genetic component to the disease, which makes family history a risk factor.

Other, less common causes of tarsal coalition include:

  • Arthritis
  • Infection
  • An injury to the foot

Tests and Diagnosis of Tarsal Coalition

To confirm a diagnosis of tarsal coalition, your doctor will first perform a physical examination to check your foot’s gait and flexibility. Often, your doctor will be able to see a flat arch on your foot, especially when you stand on your toes.

If a tarsal coalition is suspected, imaging tests will be ordered to confirm it. These could include:

  • An X-ray to look at the bone
  • A CT scan to get a detailed image of the bone
  • An MRI to inspect surrounding soft tissue

Treatment and Care for Tarsal Coalition

Generally, doctors only provide treatment for a tarsal coalition if it is causing symptoms. Nonsurgical treatments include:

  • Resting the feet to reduce stress on the tarsal bones
  • Receiving steroid injections for fast pain relief
  • Being fitted for orthotic insoles to stabilize the foot and provide support
  • Wearing a cast or boot to give the tarsal bones time to relax

If these methods are unsuccessful, surgery may be necessary. This could involve:

  • Fusion of the joint to limit movement and keep the bones securely in the proper position
  • Resection of the tarsal coalition, which involves cutting out the tarsal coalition and using fatty tissue or muscle from another part of the body to repair the area