Conditions + Treatments

Tarsal Coalition in Children

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"The first line of treatment for tarsal coalition is to rest the foot for about a month, then use arch supports and physical therapy. For about half the kids who receive this conservative treatment, their pain goes away, and they may never need surgery."

–Samantha Spencer, MD, orthopedic surgeon, Boston Children's Hospital

If your child has been diagnosed with tarsal coalition, you’ll have concerns and questions about her health, treatment, recovery and other issues. It may comfort you to know that Boston Children’s Hospital is a world leader in pediatric orthopedics, and we have a wealth of experience helping children with this fairly common condition. We specialize in innovative, family-centered care that supports your child and family.

What to know about tarsal coalition
The bones of the foot found at the top of the arch, the heel and the ankle are called the tarsal bones. A tarsal coalition is an abnormal connection between two or more of these bones. These coalitions can form across joints of the foot or can occur between bones that don't normally have a joint between them.

  • Although the condition is congenital present early in life, your child may not experience pain until she’s between 8 and 16 years old.
  • The chief symptom is pain—often recurring ankle pain or unexplained ankle sprains.
  • Your child may experience rigidity and stiffness in around her ankle, and a decreased range of motion.
  • Some researchers believe tarsal coalitions are an inherited trait, passed from parent to child. However, there is no gene identified at this point.
  • About 25 percent of children with tarsal coalition have a rigid flat foot.
  • Experts estimate that 3 to 5 percent of people have a tarsal coalition. Many never know they have this condition.
  • Treatment can be non-surgical or surgical, depending on its severity.
  • A severe case of tarsal coalition can interfere with a child’s foot function, and may alter a child’s activity level, but it’s not life- or limb-threatening.
  • Many children with the condition never need treatment. Of those who do need treatment, some don't need surgery.

How Boston Children's Hospital approaches tarsal coalition
The goal of treatment is to reduce the pain in your child's foot. At Children's, doctors take conservative, non-surgical approaches first. If pain persists despite these efforts, surgeons will be ready to help, and your child will consult with doctors for exercises to restore range of motion.

Whatever observation or treatment your child needs, you can have peace of mind knowing that as a national and international orthopedics referral center, our Orthopedic Center has vast experience treating children with every kind of developmental condition, some of which few other pediatric hospitals have ever encountered. As a result, we can provide expert diagnosis, treatment and care for every severity level of tarsal coalition.

One of the first programs. Our Orthopedic Center is one of the world’s first comprehensive pediatric orthopedic programs, and today is the largest pediatric orthopedic surgery center in the United States, performing more 6,000 procedures each year. Our program, consistently ranked among the top in the country by U.S.News & World Report, is the nation’s preeminent care center for children and young adults with developmental, congenital, post-traumatic and neuromuscular problems of the musculoskeletal system.

The world's most extensive pediatric research enterprise

At Boston Children’s, we’re known for our innovative treatments and a research-driven approach. We’re home to the world’s most extensive pediatric research enterprise, and we partner with elite health care and biotech organizations around the globe. But as specialists in family-centered care, our physicians never forget that your child is precious, and not just a patient. 

Orthopedic care in lots of places

Boston Children’s physicians provide orthopedic care at locations in Lexington, Peabody, Weymouth and Waltham, as well as at our main campus in Boston.

Tarsal coalition: Reviewed by Samantha Spencer, MD

© Boston Children's Hospital, 2012

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- Sandra L. Fenwick, President and CEO

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