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Pediatric Tarsal Coalition Care Pune
Get expert tarsal coalition treatment in Pune with pediatric orthopedic surgeons providing pain relief, foot correction, and improved joint mobility.
Overview
Tarsal coalition is a medical condition where two or more bones in the foot become abnormally connected through bone, cartilage, or fibrous tissue. This connection restricts normal movement between the affected bones, leading to pain and mobility issues. While the condition can affect adults, it’s most commonly diagnosed in children and adolescents between ages 8-16, when bones mature and symptoms become more apparent. Understanding tarsal coalition syndrome is essential for parents and patients, as early recognition and treatment can significantly improve outcomes and prevent long-term complications.
Symptoms
Tarsal coalition symptoms typically don’t appear until late childhood or adolescence, as the abnormal connection becomes more rigid with age. The most common signs include:
- Tarsal coalition pain, particularly on the outer side of the foot or around the ankle
- Stiffness and reduced range of motion in the foot
- Frequent ankle sprains or tendency for the ankle to “roll”
- Flatfoot appearance (loss of normal arch)
- Fatigue or discomfort following physical activity
- Difficulty walking on uneven surfaces
- Muscle spasms in the leg or foot
These symptoms often worsen with increased activity and may improve with rest. Parents should pay attention to children who complain of persistent foot pain or seem to avoid physical activities they once enjoyed.
Causes
Tarsal coalition causes are primarily congenital, meaning the condition is present at birth due to abnormal development of bones, cartilage, or connective tissue in the foot. The exact mechanisms aren’t always clear, but genetic factors play a significant role in foot bone development. In rare cases, the condition can develop later in life due to trauma, infection, or arthritis, though this is uncommon.
Risk Factors
The primary risk factor for developing this condition is family history. It can run in families, and children with affected parents or siblings face increased risk. Additional risk factors include:
- Congenital foot abnormalities present at birth
- Certain genetic syndromes affecting bone development
- Previous foot injuries or infections (rare causes)
Lifestyle or environmental factors during childhood don’t contribute to the development of congenital tarsal coalition.
Diagnosis
Diagnosing tarsal coalition begins with a thorough medical history and physical examination by a tarsal coalition specialist. Healthcare providers look for signs of limited foot motion, flatfoot deformity, and tenderness over specific foot areas. To confirm the diagnosis and determine the extent of the coalition, imaging studies are essential:
- Tarsal coalition x ray: Often the first imaging test, useful for detecting bony coalitions and ruling out other conditions
- CT scans: Provide detailed bone images, especially helpful for complex coalitions
- MRI: Useful for identifying coalitions made of cartilage or fibrous tissue that may not show on X-rays
Early diagnosis is crucial to prevent long-term complications and guide appropriate tarsal coalition treatment.
Types
| Type | Bones Involved | Frequency |
|---|---|---|
| Calcaneonavicular | Calcaneus & Navicular | Most common (~45%) |
| Talocalcaneal | Talus & Calcaneus | Second most common (~45%) |
| Talonavicular | Talus & Navicular | Rare |
| Other types | Other tarsal bones | Very rare |
Treatment
Tarsal coalition treatment depends on symptom severity, coalition type and location, patient age, and activity level. Treatment approaches include:
Non-Surgical (Conservative) Treatments
- Rest and activity modification to reduce pain-causing activities
- Immobilization using a cast or walking boot to limit movement and reduce inflammation
- Tarsal coalition physical therapy: Exercises to improve flexibility, strength, and gait patterns
- Orthotic devices: Custom shoe inserts to support the foot and relieve pressure
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and swelling management
Surgical Treatments
When conservative measures fail to relieve symptoms, tarsal coalition surgery may be recommended:
- Resection (removal) of the coalition: Most effective for smaller, isolated coalitions
- Fusion (arthrodesis) of affected joints: Considered for severe cases or when arthritis is present
Tarsal coalition surgery in child patients requires careful consideration of growth and development factors. Surgical outcomes are generally good, especially when performed before significant joint damage occurs.
Rehabilitation
Rehabilitation plays a crucial role in recovery, particularly after surgery. Tarsal coalition physical therapy may include:
- Range of motion exercises to restore foot flexibility
- Strengthening exercises for foot and ankle muscles
- Gradual return to activity under healthcare provider supervision
- Gait training to correct walking patterns and prevent future problems
- Balance and proprioception exercises
Adherence to rehabilitation protocols helps ensure optimal outcomes and prevents complications.
Complications
If left untreated or treatment is delayed, tarsal coalition can lead to several complications:
- Chronic pain that interferes with daily activities
- Progressive flatfoot deformity
- Arthritis in adjacent joints due to abnormal stress distribution
- Reduced mobility and difficulty with physical activities
- Increased risk of ankle sprains and injuries
- Muscle weakness and imbalances
Early intervention can help prevent or minimize these complications, emphasizing the importance of seeking medical attention for persistent foot pain.
Prevention
There is no known way to prevent tarsal coalition since it’s primarily a congenital condition. However, early recognition and treatment can prevent complications and improve long-term outcomes. Parents should seek medical evaluation if their child experiences persistent foot pain, stiffness, or difficulty with physical activities.
Living With Tarsal Coalition
Most children and adolescents with tarsal coalition can lead active, healthy lives with appropriate management. Important considerations include:
- Following treatment recommendations and using orthotics as directed
- Monitoring symptoms and reporting any worsening pain or functional changes
- Choosing supportive footwear with good arch support and cushioning
- Staying active within prescribed limits, focusing on low-impact activities
- Attending regular follow-up appointments to monitor foot development
- Maintaining open communication with healthcare providers about concerns
With proper care, most children can return to normal activities, including sports, after successful treatment.
Key Takeaways
- Tarsal coalition is an abnormal connection between foot bones, most commonly affecting children and adolescents aged 8-16
- Tarsal coalition symptoms include foot pain, stiffness, frequent ankle sprains, and flatfoot appearance
- The condition is primarily genetic and congenital, often running in families
- Diagnosis requires physical examination and imaging studies like X-rays, CT scans, or MRI
- Treatment options range from conservative measures including physical therapy and orthotics to surgery for severe cases
- Early intervention by a tarsal coalition specialist can prevent complications such as chronic pain and arthritis
- Most children can return to normal activities with appropriate treatment and rehabilitation
- At Sancheti Hospital, our experienced orthopedic specialists provide comprehensive care for tarsal coalition, from accurate diagnosis using advanced imaging to personalized treatment plans including both conservative and surgical options, ensuring the best possible outcomes for young patients.
Meet Our Pediatric Orthopedic Specialists
Patient Stories & Experiences
The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.
Vinita Singh
The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!
Parvati
I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.
Balaji Kharat
I'm a police officer, and I'm extremely thankful to Sancheti Hospital for treating my fracture without surgery.
Shantilal
My life has completely changed after the knee replacement surgery at Sancheti Hospital. It's like I can finally live again!
Kalpana Lepcha
The knee pain I've carried for years finally went away with the help of Sancheti Hospital.
Karuna
I can't believe that I get to finally live a normal and happy life, all thanks to the knee surgery I had at Sancheti Hospital.
Kishore Bhosle
Frequently Asked Questions
At what age does tarsal coalition usually cause symptoms?
Symptoms typically appear in late childhood or adolescence (ages 8-16), as the abnormal connection hardens and restricts foot motion.
Can tarsal coalition heal on its own?
No, the abnormal connection doesn’t resolve without treatment, but some mild cases may not require intervention if symptoms are manageable.
Is surgery always necessary for tarsal coalition?
No, many cases can be managed with non-surgical treatments including physical therapy and orthotics. Surgery is considered only when conservative methods fail to relieve symptoms.
Will my child be able to play sports after treatment?
Most children can return to sports and normal activities after successful treatment and rehabilitation, though this depends on the severity of the condition and response to treatment.
How long does recovery take after tarsal coalition surgery?
Recovery varies depending on the type of surgery and individual factors, but most patients can expect 3-6 months for full recovery with proper rehabilitation.
