Tarsal Coalition in Children

Tarsal coalition (a congenital fibrous, cartilaginous, or bony connection between two bones) classically presents with recurrent ankle sprains or with insidious onset of a painful, stiff flatfoot. Flatfoot is a benign finding most of the time, but it is important to distinguish the rigid flatfoot from the flexible flatfoot. A patient with recurrent sprains of the ankle or a stiff flatfoot should be evaluated for a tarsal coalition. The key to making the diagnosis is careful examination for stiffness in the subtalar joint and appropriate imaging studies. Both nonoperative and operative measures can be used to treat this condition.