Tarsal Coalition or Peroneal Spastic Flatfoot: Signs, Causes, Diagnosis, Treatment- Surgery
Tarsal Coalition or Peroneal Spastic Flatfoot is a congenital medical condition in which the tarsal bones in foot get fused together. Sometimes, other conditions such as arthritis in the joints, injury to the ankle may also result in Tarsal Coalition or Peroneal Spastic Flatfoot. There are seven tarsal bones in the body. These bones are calcaneus, talus, navicular, cuboid and three cuneiform bones.
Signs of Tarsal Coalition or Peroneal Spastic Flatfoot
Affected person starts experiencing symptoms after attaining complete maturity of bones, usually between 10 and 17 years of age. Although in some cases, patients remain asymptomatic and develop symptoms much later in life, especially if they indulge in any physical exercise or have suffered from ankle sprain.
- Pain in midfoot in young adults after vigorous physical exertion.
- Tarsal Coalition or Peroneal Spastic Flatfoot comes to surface if the patient has suffered from a previous ankle sprain and the pain continues after that.
- There is collapsed foot arch or flat foot.
- There is diminished ankle joint movement.
- Patient may limp with ambulation.
- Presence of stiffness in ankle and foot.
- There may be some symptoms of tarsal tunnel syndrome triggered by undiagnosed Tarsal Coalition or Peroneal Spastic Flatfoot.
- X-ray confirms osseous coalition and MRI shows a fibrous coalition.
Causes of Tarsal Coalition or Peroneal Spastic Flatfoot
The commonly affected joints are calcaneonavicular joints and talocalcaneal joint. Tarsal Coalition or Peroneal Spastic Flatfoot is a condition which commonly affects young children and adolescents. The fibrous or cartilaginous joints in the bones begin to harden resulting in reduced range of motion in the hindfoot. This puts significant strain on ankle joint. Other conditions such as arthritis, injury to the ankle may also sometimes result in tarsal coalition in later stages of life.
Diagnosis of Tarsal Coalition or Peroneal Spastic Flatfoot
- Physical examination with complete medical history.
- X-ray helps in confirming diagnosis.
- MRI helps in confirming the diagnosis.
Treatment for Tarsal Coalition or Peroneal Spastic Flatfoot
- A cast or a walking boot is used in order to give the affected foot some rest. This helps in reducing pain and calming down inflammation.
- Insoles or orthotics can be used to correct any biomechanical problems.
- Corticosteroid injections may be used for pain relief.
- Exercises or physical therapy should be started after complete healing to improve range of motion and flexibility.
Surgery for Tarsal Coalition or Peroneal Spastic Flatfoot
If the patient does not get benefit from conservative measures, then surgical procedure is needed. Surgery comprises of either excising excess bone or complete fusion of affected joints.