Tarsal Coalition Treatment Guidelines Handout

What is tarsal coalition?

Tarsal coalition refers to an abnormal connection of fibrous tissue between the tarsal bones of the feet. There are seven tarsals that comprise the mid and hind foot, located in the ankle, heel, and arch of the foot. The condition is associated with pain and reduced mobility in the feet, which can impact the patient's ability to perform many everyday functions.

Many tarsal coalitions are due to a genetic condition in which two or more bones fuse together during fetal development. In around half of cases, both feet will be affected. However, in some rare cases tarsal coalition occurs as a result of infection, injury or arthritis. Often, tarsal coalition results in a rigid flat foot, causing pain and, in some cases, having debilitating impacts on mobility.

Although infants are typically born with the condition, it is difficult to identify until the child's bones begin to mature. With this comes the onset of painful symptoms, usually in mid to late childhood. However, most children born with tarsal coalition will never develop symptoms and therefore do not require treatment.

Treatment for tarsal coalition

There are several options to relieve symptoms and alleviate pain associated with tarsal coalitions. Initial treatment typically involves conservative measures for pain relief and mobility. In the case of bilateral tarsal coalition, the severity and specific treatment needs may vary between the feet. Here are some of the common ways to treat and manage tarsal coalition:

Orthotics

Orthotic treatments can work to relieve pain and improve physical functioning by compensating for the the pressure or stress on the affected joint. Shoe inserts, or arch supports, are custom made to fit a child's foot, often to correct flat feet. Orthotics can help improve a child's range of motion if they are having difficulty with walking or foot function.

Physical therapy

Physical therapy is a common way to alleviate painful symptoms and build strength and mobility in the foot and ankle. It helps restore range of motion in the foot and ankle through a series of strength building exercises.

Physical therapy may only be necessary for a limited time, such as when recovering from tarsal surgery. In some cases, though, patients may benefit from ongoing, regular strength and range of motion exercises.

Surgical treatment

There are several types of surgical intervention for tarsal coalition, depending on the severity, pain levels, and specific location of the abnormal connection. Some common surgeries include resection and fusion surgery.  

Surgery is only necessary in severe cases or when symptoms have not responded to conservative treatment. It must be performed within a certain window to be effective, as the coalition may become too rigid as the bones mature.

Other treatments for pain relief

Rest from high impact activity for several weeks may help reduce pain, as can over the counter pain relief medication such as ibuprofen. Steroid injections may also be recommended in some cases to temporarily reduce pain.

How to use our treatment guidelines handout template?

Our Tarsal Coalition Treatment Guidelines Handout offers comprehensive treatment options for this condition. Follow these steps to get started:

Step 1: Access the handout

Access the Tarsal Coalition Treatment Guidelines Handout by click the "Use template" button. This lets you customize the handout via the Carepatron app. For a PDF version, choose "Download."

Step 2: Discuss with patients

Ensure you are familiar with the treatment options listed in the guidelines. Discuss these treatment options with your patient and their parents. Make recommendations about which treatments you believe would be best suited to their needs.

Step 3: Distribute the handout

Give your patient or their parents a copy of the guidelines so they can consider their options. Work with them to come up with a treatment plan, and make any necessary referrals to an orthopedic surgeon, physical therapist, or orthotics expert.

How can healthcare professionals benefit from our template?

There are several advantages to using these Tarsal Coalition Treatment Guidelines for healthcare professional. Here is a summary of the key benefits:

Improved efficiency

These guidelines act as a quick reference tool for healthcare professionals, allowing easy comparison of treatment options without extensive research.

Improved decision making

Having a comprehensive list of ways to manage and treat tarsal coalition on hand helps healthcare professionals easily make informed recommendations to their patients.

Patient empowerment

Being able to provide patients and their families with an accessible and comprehensive list of treatment options helps engage them in the treatment planning and intervention process, empowering patients to be involved in crucial decisions and increasing the chance of compliance with treatment plans.

Enhanced communication

This handout features and easy-to-follow layout and uses accessible language, promoting shared understanding between patients and healthcare professionals and facilitating clear communication about treatment options.