Tarsal coalition: does your child have ongoing foot pain?

Tarsal coalition is a foot condition, more frequent in teenagers, that can limit function and affect wellbeing.

Mr Darius Rad, consultant paediatric orthopaedic surgeon, provides an expert insight into a tarsal coalition, including what exactly is a tarsal coalition, what are common locations and how a tarsal coalition is treated.

What is a tarsal coalition?

A tarsal coalition is a connection usually between two of the tarsal bones that form the architecture of the mid or posterior portion of the foot. This connection can be either bony or fibrous in nature and can act as a bone bridge between the two bones, where there would normally be a joint.

Which is the most common location of tarsal coalitions?

The two most common locations are the calcaneal-navicular and the talo-calcaneal. Tarsal coalition can occur across other joints too, but it is less common.

How can we suspect we have a tarsal coalition?

The most common age a child presents with a tarsal coalition is around their early teenage years. They will usually complain of foot pain, which is also associated with a rigid or semi-rigid flatfoot deformity. The reason for tarsal coalition occurring in a person’s early teenage years is due to foot bone formation, which finalises at that time. Bone coalitions (or bone bridges) only become structurally complete when a body is close to reaching skeletal maturity.

Is a tarsal coalition serious? Do they hurt?

Tarsal coalition is not a serious medical condition, however, if a child should develop such a coalition, they could suffer foot pain which is not related to any trauma. Ultimately, this would limit activities including walking, which could become a difficult task in itself.

How are tarsal coalitions treated?

The first line of treatment for a tarsal coalition is conservative, using orthotics (insoles) that are recommended by a physiotherapist, podiatrist or orthopaedic surgeon. Orthotics can be correlated later with physiotherapy if another leg or foot soft tissue structure needs to be stretched or strengthened.

If these methods of treatment fail to resolve symptoms, a paediatric orthopaedic surgeon can be of help by performing a surgical procedure which excises the bony bridge and prevents it from reoccurring.

What could happen if a tarsal coalition goes untreated?

An untreated tarsal coalition can create discomfort while performing sports, activities and even walking while going to school. This can limit a child’s function and hinder their wellbeing.

If you or your child have a tarsal coalition, don’t hesitate to visit Mr Rad’s Top Doctors profile today to receive the utmost quality orthopaedic assessment and management.