This means that two bones have an abnormal connection and prevents the bones to move normally. It occurs during the fetal development and may start to become symptomatic during adolescence or sometimes only later in life. Normally the hindfoot joints are affected and this can be associated with a stiff flat foot. Benign injuries might trigger symptoms which include pain, stiffness, tiredness and muscle spasms. Simple X rays can help but often a CT scan will be necessary to confirm the correct diagnosis.
A tarsal coalition might only be detected if symptoms do not improve after a simple sprain despite the correct treatment. Identifying the problem is crucial and once the diagnosis is confirmed (ideally with CT or MRI scan) relative rest and footwear modification will be paramount to help to eliminate the pain. In case symptoms do persist surgery might be indicated. Younger patients may benefit from removing the tissue that connects the two bones but in most cases fusing the affected bones together will be the only options to settle the pain. As the affected joints are, due to the coalition already not mobile, “knitting” the bones together will not cause any further stiffness but will permit patients to regain good function of the ankle/foot. Pain will settle once the bones have healed together and the operation will permit to realign the often flat foot at the same time.