A Tarsal coalition is a fusion between two bones in the rearfoot or tarsus
Tarsal coalition is a condition characterized by the abnormal fusion of two or more bones in the tarsal region of the foot. The tarsal region includes seven bones known as the tarsal bones, which are located between the leg bones (tibia and fibula) and the bones of the forefoot (metatarsals). Tarsal coalition typically affects the bones in the back of the foot, specifically the talus, calcaneus, and sometimes the navicular bone.
The fusion of these bones can be either fibrous, where there is a bridge of fibrous tissue connecting the bones, or osseous, where there is actual bony fusion. This fusion restricts the normal movement and flexibility of the affected joints, leading to a range of symptoms and potential complications.
The exact cause of tarsal coalition is not fully understood, but it is believed to be a congenital condition, meaning it is present from birth. It often becomes apparent during late childhood or adolescence when the bones are still developing and maturing. In some cases, tarsal coalition may also result from trauma or arthritis.
Common symptoms associated with tarsal coalition include:
- Foot and ankle pain, typically worsened with activity and relieved with rest.
- Stiffness and limited range of motion in the affected joint(s).
- Fatigue or muscle cramps in the leg or foot.
- Abnormal gait or walking pattern.
- Flatfoot or high-arched foot deformity.
The diagnosis of tarsal coalition is made through a combination of clinical evaluation, medical history, and imaging studies such as X-rays, CT scans, or MRI scans. These tests help visualize the abnormal bony fusion or fibrous connection between the tarsal bones.
Treatment for tarsal coalition depends on the severity of symptoms and the impact on daily activities. Non-surgical approaches are typically tried first and may include:
- Activity modification: Avoiding activities that worsen symptoms or cause pain.
- Orthotic devices: Custom shoe inserts or orthotic devices can provide support and reduce excessive motion in the affected joints.
- Physical therapy: Stretching and strengthening exercises can help improve joint flexibility and alleviate symptoms.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to reduce pain and inflammation.
If conservative measures do not provide sufficient relief, or if the condition is severe and significantly affecting quality of life, surgical intervention may be considered. The goal of surgery is to separate the fused bones and restore normal joint motion. The specific surgical technique used will depend on the location and extent of the tarsal coalition.