Tarsal Coalition Evaluation and Surgical Management
Summary
Tarsal coalition denotes an abnormal connection between two or more tarsal bones, most commonly involving the calcaneonavicular or talocalcaneal joints. Patients typically present during adolescence with hindfoot pain, restricted subtalar motion and a rigid flatfoot deformity. Clinical assessment is complemented by weight-bearing radiographs, but advanced imaging with computed tomography (CT) and magnetic resonance imaging (MRI) has become pivotal for delineating the nature (fibrous, cartilaginous or osseous) and extent of the coalition. Precise classification informs surgical planning, which ranges from isolated resection with interposition grafting to combined procedures such as subtalar arthroereisis or arthrodesis in more extensive disease. Minimally invasive arthroscopic techniques are increasingly employed to reduce soft-tissue morbidity. Overall, contemporary management strives to restore hindfoot mobility, relieve pain and correct deformity while minimising complications and preserving joint function.
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Tarsal Coalition Evaluation and Surgical Management publication trend
The graph below shows the total number of articles in tarsal coalition evaluation and surgical management across all publications each year (not limited to Nature Index journals).
Technical terms
Tarsal coalition: Abnormal fibrous, cartilaginous or osseous bridging between tarsal bones causing hindfoot pain and stiffness.
Fibrocartilaginous coalition: A non-osseous connection composed of fibrous tissue with cartilage elements, often less rigid than bony coalitions.
Osseous coalition: A bony bridge between two tarsal bones, leading to rigid joint fixation.
Magnetic resonance imaging (MRI): A non-ionising imaging modality providing high-resolution soft-tissue and bone marrow contrast.
Computed tomography (CT): A cross-sectional imaging technique offering detailed visualisation of bone anatomy and coalition morphology.
Arthroereisis: A surgical procedure in which an implant is placed in the sinus tarsi to limit excessive pronation and support medial arch height.
Interposition graft: Biologic or synthetic material placed between resected coalition surfaces to prevent re-ossification and preserve joint motion.
Arthroscopic resection: Minimally invasive excision of coalition tissue using small portals and endoscopic instruments.
References
- How accurate is MRI for diagnosing tarsal coalitions? A retrospective diagnostic accuracy study. European Radiology (2023).
- A new classification of talocalcaneal coalitions based on computed tomography for operative planning. BMC Musculoskeletal Disorders (2021).
- 8 out of 10 patients do well after surgery for tarsal coalitions: A systematic review on 1284 coalitions. Foot and Ankle Surgery (2022).
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