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Specific treatment for tarsal coalition will be determined by your child's physician based on:
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your child's age, overall health, and medical history
- the extent of the condition
- your child's tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
- your opinion or preference
There are a variety of non-surgical and surgical methods used to treat a tarsal coalition. The primary goal of conservative, non-surgical treatment is to reduce pain and muscle spasm by further reducing range of motion in the affected joint or joints. This is achieved by the use of orthotics, which are special, custom-made shoe inserts that support affected joints. An injection of an anesthetic and a steroid, such as cortisone, may also be given to provide temporarily relief of pain. The doctor may also prescribe anti-inflammatory medication.
Pain may persist despite conservative measures. In that case, your child's doctor will probably recommend surgery. The type of surgery depends on the type and location of the coalition and whether arthritis is involved, and, if it is, how extensive arthritis is. If there are no arthritic changes, the union between the bones is usually resected, so that normal range of motion can occur. However, in some cases, surgery is aimed at limiting the range of motion in the joint that causes pain. In this case, the surgery involves fusing affected joints.
After surgery, as part of the recovery process, a splint or cast, along with crutches are used to immobilize the foot and keep the foot from bearing weight. Exercises to restore muscle tone and range of motion are encouraged, along with walking as soon as possible after adequate healing.
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