Tarsal coalition

Tarsal coalition

Tarsal coalition is a congenital condition in which there is an abnormal connection between the bones of the hind foot. Two of the tarsal bones fail to separate from each other during early development.  The abnormal connection is composed of bone, cartilage or fibrous tissue and will lead to limited motion. There are three types of osseus tarsal coalitions that causes a stiff foot that often flattens in kids.



  • Pain and stiffness in the foot and ankle
  • Muscle spasms in the leg
  • Every day activities are difficult
  • Severe Flatfoot

How are Tarsal Coalitions diagnosed?

Since the bones in early childhood are primarily made of cartilage, tarsal coalitions are often unnoticed until childhood or adolescence when children start to have pain, stiffness or swelling. X-rays do not show cartilage, so they are not accurate until adolescence when it turns to bone. Sometimes a CT scan or MRI will be required in addition to weight bearing x-rays to help determine the severity of the coalition. Also, the foot is more prone to injury with activity as cartilage matures into bone. Some children never have symptoms and do not require treatment. Conservative treatment includes, decreasing sports activities, Over-the-counter anti-inflammatory medication, icing and custom shoe inserts/orthotics to help limit the motion.


At the Foot, Ankle and Leg Vein Center we try conservative measures first, however if initial treatment is unsuccessful surgery is indicated.  The exact surgical procedure depends on the type and severity of the tarsal coalition and the age of the patient, which will be determined after careful evaluation. Resection is the most common type of surgery because it increases foot motion once the coalition is removed.  When arthritis is present an arthrodesis or fusion procedures will be indicated to relieve pain and improve function. Risks, complications and you’re peri operative care will be explained to you before the surgery.