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A tarsal coalition is an abnormal connection between two or more tarsal bones caused by failure of mesenchymal segmentation.
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The two most common tarsal coalitions are calcaneonavicular coalition (CNC) and talocalcaneal coalition (TCC). Both CNC and TCC can be associated with significant foot and ankle pain and impaired quality of life; there may also be concomitant foot and ankle deformity.
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Initial, non-operative management for symptomatic tarsal coalition commonly fails, leaving surgical intervention as the only recourse.
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The focus of this article is to critically describe the variety of methods used to surgically manage CNC and TCC. In review of the pertinent literature we highlight the ongoing treatment controversies in this field and discuss new innovations.
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The evidence-based algorithmic approach used by the authors in the management of tarsal coalitions is illustrated alongside some clinical pearls that should help surgeons treating this common, and at times complex, condition.
Cite this article: EFORT Open Rev 2020;5:80-89. DOI: 10.1302/2058-5241.5.180106
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confirmed with neurophysiological studies. The role of imaging is poorly defined. Dynamic ultrasound may demonstrate abnormal subluxation of the nerve around the medial epicondyle at the elbow. Non-operative management is recommended in mild cases of
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grip. 45 With development of minimally invasive, percutaneous techniques there has been a trend towards operative management of non or minimally displaced waist fractures. The short-term advantage of operative treatment is return to work or sports
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operatively treated tibial shaft fractures . Clin Orthop Relat Res 2005 ; 438 : 221 – 232 . 10. Bhandari M Tornetta P III Sprague S et al. Predictors of reoperation following operative management of fractures of the
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; 42 : 262 – 267 . 38. d’Astorg H Rampal V Seringe R Glorion C Wicart P . Is non-operative management of childhood neurologic cavovarus foot effective? Orthop Traumatol Surg Res 2016 ; 102 : 1087
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particular non-operative treatment regimen. 50 The author applies the three-phase non-operative management protocol described by Kocher et al. 15 The first phase involves knee immobilization for four to six weeks with crutch-protected, partial
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with an associated vascular injury, our first action should be to perform a closed reduction of the fracture. There is no evidence supporting the use of angiography in pre-operative management. 83 , 84 In the absence of significant associated
