Causes and risk factors
In tarsal coalition, there occurs an abnormal connection between two or more bones. The bones are connected to each other by some fibrous tissue or bone or some cartilages. This abnormal connection is caused due to improper development of the bone during fetal life. Mutations in the genes lead to this abnormal fusion. Although rare, certain other causes like injury, arthritis or infection of the bone can also lead to tarsal coalition.
Clinical presentation:
This condition develops during birth; however, the symptoms are seen by the time of adolescence. The most common tarsal bone to be involved are calcaneous and navicular bone or calcaneous and talus bone. At times, the patient can be asymptomatic and hence the condition often remains undiagnosed. In most of the cases, bilateral affection can be seen. The person usually comes up with complaints of pain in the affected foot along with stiffness. The pain is aggravated by physical activity. Flat foot occurs. The legs become fatigued. As walking and activity becomes difficult, rolling of ankle can occur which can cause easy ankle sprains or fractures. The patient can limp.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the patient and the physical examination carried out by the orthopedic doctor. Investigations which are done are x-ray of the bone; routine x-rays or specialized digital x-rays along with CT scan and MRI are advised.
Treatment:
Treatment is needed in cases where the symptoms are present. Rest and avoidance of stressful activity is the first step to be implemented. Analgesic or nonsteroidal anti-inflammatory drugs are advised by the orthopedic doctor. Steroid injection can be given to allay the pain. Temporary cast application or use of boot or shoes with heel cups and wedges are advised. In severe cases which are not responding to the conservative method of treatment may need surgical intervention. Either resection of the coalition or joint fusion method is adopted depending upon the bones involved and presence of arthritis.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. Certain yoga exercises can also be helpful in strengthening the muscles.
Facts and Figures:
It is estimated that 1 out of every 100 people must be having tarsal coalition.
