TARSAL COALITION

TYPES

Tarsal coalition can be classified into different types based on the specific bones involved and the nature of the abnormal connection. The most common types of tarsal coalition include:

• Talocalcaneal coalition: This is the most common type of tarsal coalition, involving an abnormal connection between the talus bone (located in the ankle) and the calcaneus bone (heel bone).
• Calcaneonavicular coalition: In this type, there is an abnormal connection between the calcaneus bone and the navicular bone, which is located in the midfoot.
• Talonavicular coalition: This type involves an abnormal connection between the talus bone and the navicular bone.
• Cuboid-navicular coalition: This type involves an abnormal connection between the cuboid bone (located on the outer side of the foot) and the navicular bone.

These different types of tarsal coalition can cause similar symptoms and may require similar treatment approaches. However, the specific location and extent of the abnormal bone connection can influence the severity of symptoms and the treatment options recommended by healthcare professionals.

SYMPTOMS

Tarsal coalition can cause a variety of symptoms that can vary in severity from person to person. Common symptoms of tarsal coalition include:

• Foot and ankle pain: Pain is one of the most prevalent symptoms of tarsal coalition. The pain is typically localized to the affected area and may worsen with physical activity or prolonged standing.
• Stiffness: Restricted movement and decreased flexibility in the affected foot are common symptoms. The abnormal bone connection can limit the normal range of motion and result in stiffness, making it difficult to perform certain movements.
• Flatfoot deformity: Tarsal coalition can contribute to the development of a flatfoot deformity. The natural arch of the foot may be reduced or completely absent, leading to an altered foot structure and gait.
• Muscle fatigue and cramping: The abnormal bone connection can cause surrounding muscles to work harder to compensate for the restricted movement. This increased workload can lead to muscle fatigue and cramping, especially during physical activity.
• Swelling and inflammation: In some cases, tarsal coalition can cause swelling and inflammation in the affected area. This can further contribute to pain and discomfort.

DIAGNOSIS

The study of the patient’s medical history, a physical examination, and imaging studies are often combined to make the diagnosis of tarsal coalition. Following are a few typical actions that are conducted throughout the diagnostic process:

• Medical history evaluation: Your healthcare provider will start by questioning you about your symptoms, such as the place, how long they have lasted, and how bad they are. They can also ask you about any past illnesses or injuries that could be connected to your symptoms.
• Physical examination: Your feet and ankles will be carefully examined physically. Your foot structure will be examined for any obvious deformities or anomalies, stability, and range of motion.
• Imaging examinations: Tarsal coalition is often determined using X-rays. They can provide precise pictures of the bones and make it easier to see any strange connections between them. To further assess the disease, doctors may sometimes request further imaging tests like computed tomography (CT) scans or magnetic resonance imaging (MRI).

TREATMENT

The treatment of tarsal coalition depends on various factors, including the severity of symptoms, the age of the patient, and the specific type and location of the coalition. Treatment options may range from conservative measures to surgical intervention. Here are some common approaches:

1. Conservative treatment: This course of action is often taken into account in moderate situations or as a preliminary measure before contemplating surgery. It might contain:

• Rest and activity modification: Steer clear of activities that exacerbate symptoms and give your body time to recuperate.
• Pain management: To reduce pain and inflammation, nonsteroidal anti-inflammatory medicines (NSAIDs) or other painkillers may be recommended.
• Physical therapy: Particular stretches and exercises might help to increase flexibility, strengthen the muscles around it, and lessen discomfort.
• Orthotic devices: These may assist support the problematic region and disperse pressure by being made to order shoe inserts or orthotic devices.

2. Immobilisation: In certain circumstances, it may be advised to remain immobile with a cast or walking boot to reduce symptoms and promote healing of the coalition.
3. Corticosteroid injections: These may be used to treat pain and inflammation in the afflicted region. Usually, these injections are used with other conservative therapies.
4. Surgical intervention: In more serious situations or when conservative methods are ineffective, surgery may be an option. The coalition’s size and position, for example, will affect the kind of surgery that is performed. Surgical options might consist of:

• Resection: By surgically removing the aberrant bone connection, symptoms may be alleviated and range of motion increased.
• Fusion: In certain circumstances, it may be essential to fuse the damaged bones. This stops the abnormal movement and eases discomfort by permanently connecting the bones together.