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There are many ways you can help children and their families get the care they need.
Boston Children's Hospital's Orthopedic Center specialists provide comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care.
But in the case of tarsal coalition, about 75 percent of children with the condition never even need treatment. And of the 25 percent who do need treatment, up to one-half don't need surgery.
If needed, specific treatment for tarsal coalition will be determined by your child's physician based on:
There are several non-surgical methods used to treat a tarsal coalition. The primary goal of conservative, non-surgical treatment is to reduce pain and muscle spasms by further reducing range of motion (immobilization) in the affected joint or joints. Treatments can include:
If your child's pain persists or recurs despite conservative measures, your child's doctor will probably recommend surgery.
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 early at one to two weeks after surgery. Walking and full strengthening begins about one month after surgery.
After surgery, your child will probably stay in the hospital overnight, and be given pain medication. She'll wear a cast when she goes home; she'll need to limit her weight-bearing activities for about a month; and she may use crutches or a walker for a few weeks. At this point, therapy is aimed mostly at regaining range of motion and preventing the bone bridge (coalition) from re-forming.
After about a month she'll go into a walking boot and begin strengthening exercises. Physical therapy will help her restore her muscle strength. She'll probably be able to resume full activities, including sports, after three to six months. However, a full recovery can take up to a year.
At Boston Children's, we understand that a hospital visit can be difficult. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit the Center for Families for all you need to know about:
In particular, we understand that you may have a lot of questions when your child is diagnosed with tarsal coalition. Will my child need surgery? When will her foot be normal? Will it affect her long term? Boston Children's can help you connect with extensive resources to help you and your family through this stressful time, including:
Designed by Boston Children's psychiatrist-in-chief David DeMaso, MD, and members of his team, the Experience Journal is an online collection of thoughts, reflections and advice from kids, parents and other caregivers about a variety of medical experiences, including hip problems.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”