Tarsal Coalition

ExitCare ImageTarsal coalition is a condition that develops before birth. In this condition, an incomplete separation exists between the hind foot bones (tarsal bones). Tarsal coalition often lacks symptoms. However, it may cause problems during the teenage or early adult years.

SYMPTOMS

  • Recurring ankle sprains.

  • Rigid, flat foot (or feet).

  • Foot fatigue.

  • Pain in the hind foot that gets worse with activity.

CAUSES

During a baby's development, the tarsal bones fail to separate completely from each other.

RISK INCREASES WITH:

Family history of tarsal coalition.

PREVENTION

There are no known preventive measures.

PROGNOSIS

If left untreated, adults often develop arthritis of the joints between the tarsal bones in the foot. If treated before arthritis develops, you have a good chance of a full return to activity, with some foot stiffness.

RELATED COMPLICATIONS

  • Arthritis of the foot and ankle, due to increased stress on other joints.

  • Persistent and recurring foot and ankle pain.

  • Recurring ankle sprains.

TREATMENT

Treatment first involves the use of ice and medicine to reduce pain and inflammation. The foot may be restrained to reduce pain and swelling. Arch supports (orthotics) may be used to reduce pressure on the joints between the tarsal bones. Corticosteroid injections may be recommended to reduce inflammation. If non-surgical treatment is unsuccessful, surgery may be needed to prevent arthritis. Surgery may involve removing the bony bridge (coalition) between the tarsal bones, or fusion of the tarsal joints (eliminating motion between the joints).

MEDICATION

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines (aspirin and ibuprofen), or other minor pain relievers (acetaminophen), are often recommended.

  • Do not take pain medicine for 7 days before surgery.

  • Stronger pain relievers may be prescribed. Use only as directed and only as much as you need.

  • Injections of corticosteroids may be given to reduce inflammation. However, they can only be given a certain number of times. These injections may increase your risk of developing arthritis.

HEAT AND COLD

  • Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours, and immediately after activity that aggravates your symptoms. Use ice packs or an ice massage.

  • Heat treatment may be used before performing stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or a warm water soak.

SEEK MEDICAL CARE IF:

  • Pain, tenderness, or swelling worsens, despite treatment.

  • You experience pain, numbness, or coldness in the foot.

  • Blue, gray, or dark color appears in the toenails.

  • Any of the following occur after surgery: fever, increased pain, swelling, redness, drainage of fluids, or bleeding in the affected area.

  • New, unexplained symptoms develop. (Drugs used in treatment may produce side effects.)