Tarsal Coalition

Just got back from taking the girls to their ballet class (usually the wife does that) and ended up making the usual small talk with the other mums (not dads their unfortunately). Needless to say sometime I admit what I do for a job and the topic got to feet. This time it was actually interesting. What the mother related to me was clearly a case of tarsal coalition without me even looking at their kid (they were busy dancing). I obviously did not say much, but the really need to get to see someone who knows what they are doing. They had been mucked around by many different health professionals.

A tarsal coalition is a fusion of bone between two bones in the rearfoot (tarsus). The most common ones are a talocalcaneal coalition and a calcaneonavicular coalition. I usually like to send them for surgical consult as this is going to be there forever and if it can be removed, why not remove it? If that is not an option then some sort of foot orthoses can be used to limit motion which usually helps the symptoms.

I had to make a number of subtle suggestion as to what might be going on in this child foot and what they might need to do to get the right advice. Obviously without the benefit of an x-ray and a full examination, I was only speculating. I made this really clear to her.

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