Tarsal coalitions are a relatively common problem that can affect foot and ankle function. These occur during the development in the bones and joints of the foot and the most 2 common places they happen is between the talus and calcaneus at the middle facet of the subtalar joint and also at the calcaneal navicular joint where an abnormal connection of these bones can form.
We commonly see these start to bother patients in the younger teenage years, and they typically present with a rigid flat foot type deformity and often times have peroneal tendinitis or symptoms over the peroneal tendons associated such as spasm.
Sometimes, if the flatfoot deformity is mild, arch supports or orthotics can be a helpful treatment to try to alleviate pain.
If the foot is more rigid and very flat, orthotics do not always help these patients and sometimes surgical intervention is necessary. Coalitions can be fibrous which is more of a soft tissue connection or can be osseous where the 2 bones are connected by a bone bridge.
If less than 50% of the joint surface is affected, we typically recommend removing the coalition and fixing any associated deformities such as the flatfoot. If greater than 50% of the joint surface is affected, we sometimes recommend fusion of the joint to try to decrease the pain.
If we are removing the coalition but not fusing the joint, we often interpose different types of tissue to try and prevent the bones from growing back together such as bone wax, fat, or muscle.
The longer you leave a tarsal coalition intact, the higher chance the foot has of becoming more rigid and stiff. This also affects other joints where bone spurs and arthritis can start to grow or worsen.
If you are having any foot and ankle pain or problems, call your Colorado Springs podiatrists and foot and ankle surgeons today, so we can help you at 719-488-4664!