What is a Tarsal Coalition
A tarsal coalition is an abnormal connection that develops between two bones in the back of the foot (the tarsal bones). The tarsal bones include the calcaneus (heel bone), talus, navicular, cuboid and cuneiform bones.
While many people who have a tarsal coalition are born with this condition, the symptoms generally do not appear until the bones begin to mature, usually around ages 9 to 16. Sometimes no symptoms are present during childhood. However, pain and symptoms may develop later in life.
The connection can be composed of bone, cartilage or fibrous tissue and may lead to limited motion and pain.
Causes of Tarsal Coalition
- Congenital – tarsal coalition may occur during fetal development, resulting in individual bones not forming properly
Diagnosing Tarsal Coalition
A tarsal coalition is difficult to identify until a child’s bones begin to mature. It is sometimes not discovered until adulthood.
At the Foot an Ankle Centre we are able to provide additional information about the presence of a tarsal coalition, with ultrasound imaging
The above images shows a subtalar coalition – note the changes in the interface of the subtalar joint. Lift side shows lipping and sclerosis of the bones.
In addition to examining the foot, x-rays are sometime beneficial at detecting this problem. Advanced imaging studies may also be required to fully evaluate the condition.
(The C Sign is commonly seen with a talo-calcaneal coalition)
Treatment of Tarsal Coalition
The goal of treatment tarsal coalition is to relieve the symptoms and to reduce the motion at the affected joint. One or more of the following options may be used, depending on the severity of the condition and the response to treatment:
- More supportive footwear
- Footwear modification including rocker modification