Diagnosing tarsal coalition in medieval Exeter

The objective of this study is to estimate the frequency and types of tarsal coalition represented in medieval remains from Exeter, England.

183 individuals from the Cathedral Green site in Exeter, England.

Gross macroscopic analysis combined with radiographic examination and comparison with clinical and archaeological literature.

Eight coalitions of various forms were ultimately identified; these include five calcaneonavicular, one talocalcaneal, one calcaneocuboid, and one lateral cuneiform-third metatarsal coalition.

These frequencies are quite high for clinical imaging estimations, but consistent with other reported archaeological frequencies.

This study contributes to known frequencies of tarsal coalition in the past. It also provides descriptive diagnostic criteria for identifying tarsal coalition in archaeological populations.

Poor preservation of some of the individuals in this sample means that the true frequencies of tarsal coalition may be underrepresented.

This study should be expanded to include more archaeological sites, especially medieval British sites, to determine overall prevalence rates. Additionally, the diagnostic criteria should be compared with other examples of known tarsal coalition to further our understanding of this rare pathology.