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Portland Foot and Ankle

(503) 244-7894

Battle Ground Foot and Ankle

(360) 687-3668

Vancouver Foot and Ankle East

(360) 834-3707

Vancouver Foot and Ankle West

(360) 597-4223

What is a Tarsal Coalition?
A tarsal coalition is an abnormal connection that develops between two bones in the back of the foot (the tarsal bones). This abnormal connection, which can be composed of bone, cartilage, or fibrous tissue, may lead to limited motion and pain in one or both feet.

 

TarsalcoalitionThe tarsal bones include the calcaneus (heel bone), talus, navicular, cuboid, and cuneiform bones. These bones work together to provide the motion necessary for normal foot function.

Causes
Most often, tarsal coalition occurs during fetal development, resulting in the individual bones not forming properly. Less common causes of tarsal coalition include infection, arthritis, or a previous injury to the area.

Symptoms
While many people who have a tarsal coalition are born with this condition, the symptoms generally do not appear until the bones begin to mature, usually around ages 9 to16. Sometimes there are no symptoms during childhood. However, pain and symptoms may develop later in life.

The symptoms of tarsal coalition may include one or more of the following:

  • Pain (mild to severe) when walking or standing
  • Tired or fatigued legs
  • Muscle spasms in the leg, causing the foot to turn outward when walking
  • Flatfoot (in one or both feet)
  • Walking with a limp
  • Stiffness of the foot and ankle

Diagnosis
A tarsal coalition is difficult to identify until a child’s bones begin to mature. It is sometimes not discovered until adulthood. Diagnosis includes obtaining information about the duration and development of the symptoms as well as a thorough examination of the foot and ankle. The findings of this examination will differ according to the severity and location of the coalition.

In addition to examining the foot, the surgeon will order x-rays. Advanced imaging studies may also be required to fully evaluate the condition.

Non-surgical Treatment
The goal of non-surgical treatment of tarsal coalition is to relieve the symptoms and reduce the motion at the affected joint. One or more of the following options may be used, depending on the severity of the condition and the response to treatment:

  • Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
  • Physical therapy. Physical therapy may include massage, range-of-motion exercises, and ultrasound therapy.
  • Steroid injections. An injection of cortisone into the affected joint reduces the inflammation and pain. Sometimes more than one injection is necessary.
  • Orthotic devices. Custom orthotic devices can be beneficial in distributing weight away from the joint, limiting motion at the joint and relieving pain.
  • Immobilization. Sometimes the foot is immobilized to give the affected area a rest. The foot is placed in a cast or cast boot, and crutches are used to avoid placing weight on the foot.
  • Injection of an anesthetic agent. Injection of an anesthetic into the leg may be used to relax spasms and is often performed prior to immobilization.

When is Surgery Needed?
If the patient's symptoms are not adequately relieved with nonsurgical treatment, surgery is an option. The foot and ankle surgeon will determine the best surgical approach based the patient's age, condition, arthritic changes, and activity level.

Our Locations


Vancouver Foot and Ankle West


Vancouver Foot and Ankle East


Battle Ground Foot and Ankle


Portland Foot and Ankle


Hours of Operation

Vancouver Foot And Ankle West

Monday:

Closed

Tuesday:

Closed

Wednesday:

Closed

Thursday:

8:00 am-3:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Vancouver Foot and Ankle East

Monday:

Closed

Tuesday:

Closed

Wednesday:

9:00 AM-3:00 PM

Thursday:

Closed

Friday:

Closed

Saturday:

8:00 am-12:00pm (Every other Saturday)

Sunday:

Closed

Battle Ground Foot and Ankle

Monday:

8:00 AM-3:00 PM

Tuesday:

Closed

Wednesday:

Closed

Thursday:

Closed

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Portland Foot and Ankle

Monday:

Closed

Tuesday:

7:00 AM-2:00 PM

Wednesday:

Closed

Thursday:

Closed

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

  • "My 3rd and 4th toes on the right foot were so painful to walk for about 5 years or so. Dr Belnap clipped the tendons in the toes and clipped the nails of both feet on follow up appointments, and now I can walk without pain. I wish I had known of this procedure sooner and will surely recommend this office to friends!

    Side note: I know there has been discussion on getting access to all the x-rays from every location. Is that going to be possible in the future? It would be very helpful for surgical planning, as it is always a good idea to have a copy of the x-rays in the operating room for surgical planning purposes. The other solution I could think of is printing off the x-rays on surgical patients and scanning them into their charts as a document, so you can access them from anywhere.

    Thanks for all your help!!"
    Nancy P.
  • "Dr Belnap is very professional. He helped with my foot pain. He corrected my issues and I was pain-free by the first follow up visit!"
    Dennis B.
  • "I came to Dr Hayes from a personal referral. He has done surgery on both of my feet for bunions. It has helped me to live my busy lifestyle. I have highly recommended him to my friends"
    Susan N.