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Tarsal Coalition: the Effects of Joined Foot Bones

Some of the foot and ankle conditions that we treat here in our Austin, TX podiatric practice are easy to observe. A bunion, fungal nail infection, or a pump bump will be quite visible. Others are the result of a traumatic incident and the patient is aware of what happened. Sometimes, though, structural foot issues develop in the womb. Tarsal coalition is a prime example.

Understanding Tarsal Coalition

This genetic condition is caused by a mutation in the gene that dictates how the tarsal bones in the back of a child’s foot develop. This condition most commonly affects the calcaneus (the heel bone), the talus, and the navicular bone. The structure of these bones is such that the navicular is in front of the talus, which sits on top of the calcaneus. These tarsals are close in proximity, so when there is tissue that develops between them—like cartilage or bone—it connects the bones.

This condition will not typically cause problems at first. When your child is young, bones and tissue are still soft and malleable, so there may not be any indications of future issues. That said, if your child needs an X-ray for a different medical concern, the coalition would be evident on the scan.

The problem starts to come to light as a child grows older. A natural process of human development is that tissues strengthen and bones become harder. As this happens, your child make experience pain that comes when his or her bones cannot move as they are intended. However, even after the bones have hardened, there is a distinct chance that your child will not experience any associated foot pain. This is the case for roughly half of all children who have this coalition.

Tarsal coalition can mean lots of ankle sprainsSymptoms of Tarsal Coalition

Symptoms and signs of this condition include:

  • Pain in the ankle or the area on top of the foot that sits directly in front of the lower leg.
  • Flat feet that do not show an arch when your child rises on tiptoe (which would normally indicate flexible flatfoot).
  • Stiffness and labored mobility, particularly with regard to lateral movements.
  • Frequent ankle sprains. Sprained ankles can happen to anyone, but in this case they will be caused by an impaired ability to balance on surfaces that are uneven.
  • A noticeable limp, pain in the back half of the foot after activity, or even a withdrawal from sports or physical activities that had previously been enjoyable.

Should any of these be observed or brought to your attention by your child, Austin Foot and Ankle Specialists is here for you. We can provide an accurate diagnosis by gathering your son or daughter’s medical history, examining the feet, and using imaging tests (X-rays, CT scans) to determine whether or not tarsal coalition is present.

Effective Treatment Options

There is actually a good chance that your child will not have any noticeable symptoms, but if they do, our foot specialists will likely begin treatment by using conservative care to alleviate any pain and promote better long-term mobility. This care might include rest, a boot or cast, orthotics, and possibly pain medication. Boots, casts, and orthotics are all options that are intended to keep the foot immobile, promote stability, and relieve the amount of pressure they experience.

Our preference is to tackle tarsal coalition with conservative care, but there are times when surgery becomes a necessary option to take away the pain and allow for normal movement in the affected foot. Should it come to this, you can take comfort in the fact that our offices is staffed with the Austin’s top foot doctors. We will carefully explain your options so you can make an informed decision that is best for your child.

The Podiatrists in Our Austin, TX Offices Can Help

We are here to help you and your whole family with issues like tarsal coalition, but can provide effective treatment for any foot or ankle condition that affects you. Austin Foot and Ankle Specialists is committed to providing the first-class care and service you deserve. Contact our Austin, TX office by using our online form or calling (512) 328-8900 to schedule your appointment today.

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Dr. Craig H. Thomajan, DPM, FACFAS, FAENS
Founder and Managing Partner of Austin Foot and Ankle Specialists