Optimal Surgical Management of Tarsal Coalitions

Tarsal coalitions are common, but fortunately the majority of patients with coalitions are asymptomatic and do not require intervention. When symptomatic, preoperative radiographs and CT scans are useful to characterize the type and extent of coalition. If a trial of nonsurgical management fails, resection, deformity correction, and triple arthrodesis may be considered. Barring contraindications, resection has been shown to be an effective and reliable first line surgical option. Arthrodesis should be reserved for cases of failed resection or significant arthritis. Associated deformity should be factored into patient evaluation and surgical management.