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Tarsal Coalition
July 2003

Q. My husband was diagnosed with tarsal coalition in both feet. His doctor recommended surgery one foot at a time. He had surgery on his left foot for the second time in April. Since the surgery, he has been in severe pain. I had to take him to the emergency room to control the pain.

The doctor checked for a blood clot but that was negative. The surgery consisted of fusions and moving of tendons to other parts of the foot and removal of a tendon that was arthritic. The doctor said he would be in pain for 6 months and he had to tough it out.

My husband is also having trouble getting around because he has tarsal coalitions in his right foot too and can't take up the slack for left foot. Could you give me any advice on what might be wrong and what I could do to help my husband?

A. The tarsal bones are the sturdy, block-like bones that make up the foot structure leading to the long bones of the foot and the toes. One of these bones, the talus, is the bone that is part of the ankle joint, and the calcaneus is the heel. In the uncommon condition known as tarsal coalition, two or more of these bones become fused together preventing normal motion.

In some cases in childhood it is mild and painless, and does not require treatment. In other cases as the child grows, the condition can limit foot motion and impair mobility, as well as cause pain. Some cases do well with simple casting, but more severe cases require surgical treatment to break up the fusion and try to correct the anatomy.

Treatment should be directed by an orthopedic surgeon with expertise in foot conditions, and may require consultation with a pain management specialist as well.

http://footandankle.mdmercy.com/conditions/flatfeet/tarsal.html

http://www.orthoseek.com/articles/tarsalcoal.html

http://podiatry.temple.edu/Clinic/tarsal.htm

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