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A tarsal coalition is an abnormal connection of bones in the foot, in which the bones fail to properly separate. The condition can occur in just one or both feet. It may be caused by genetics and run in families, or it may be a congenital condition, occurring during fetal development and present at birth. Previous injuries, infection, and arthritis are some less common causes.
Some of the tarsal bones in the foot include the calcaneus, also known as the heel bone; the navicular; the talus; and the cuboid bones. Normal function of the foot is made possible by these bones properly working together, and problems result when these bones are joined abnormally. The joining of the calcaneus and talus bones results in a talocalcaneal coalition, while the failure of separation between the calcaneus and the navicular bones results in a type of coalition known as calcaneonavicular tarsal coalition.
The abnormal connections between the tarsal bones are not limited to the bones themselves; improper connections may also exist between the cartilage that joins the bones of the foot. Although some people are born with this condition, many will not develop problems until the late teen years. In many cases, individuals do not know they have this condition until they visit a doctor for what may seem common foot ailments and are then diagnosed.
Some common symptoms of tarsal coalition include stiffness in the foot, a lack of mobility, and extreme pain. The foremost symptom of this condition is pain, especially while walking. Other symptoms can include legs that become easily tired and have frequent spasms. Additionally, people with this condition may appear to have flat feet.
If a doctor suspects an individual of having a tarsal coalition, the patient will typically be sent to have diagnostic tests performed. Some tests commonly used to diagnose this condition include x-rays, a computed tomography (CT) scan, and a magnetic resonance imaging (MRI) test. The MRI may be especially useful in making a diagnosis because it can aid in screening the soft tissues of the foot as well as bones, and may reveal a problem with the cartilage.
Tarsal coalition treatment may involve medications, orthotic devices, and surgery. Anti-inflammatory medications may be used to lessen pain caused by the condition, and steroid injections may also be given to relieve inflammation. Additionally, pain management may be attempted by using shoe inserts and other orthotic devices to support the foot upon movement. In severe cases of this condition, surgery may be necessary.
Surgery for tarsal coalition may be recommended if all other efforts fail to give the patient relief of problematic symptoms. During this surgery, the surgeon will typically remove the abnormality joining the bones together or further fuse the joints. The general purposes of the surgery is to relieve discomfort and restore mobility and normal function to the foot. Symptoms, age, and the level of daily activities may be factors considered before undergoing this type of surgery. After completing an examination and making an official diagnosis, a doctor will be able to decide the best method of treatment for an individual with a tarsal coalition.