Do you or your child experience frequent pain in your feet, especially in the ankle area? Does it feel a little strange and uncomfortable when you walk? Then perhaps it is very important for you to be aware of this condition called "tarsal coalition" that we are going to talk about today. Don't worry, this is not very common, but it is good to be aware of this.
What is this Tarsal Coalition? Let's understand it very simply.
Okay, first let's look at what these "tarsal" bones are. The tarsal bones are a group of bones that are located on the back of your foot, at the point where your heel meets your ankle. They're like little pebbles that are joined together. These bones are connected to each other and work together to help our feet function properly, to walk, run, and jump.
Now, what is a "coalition"? Simply put, a tarsal coalition is when two or more of these tarsal bones come together in an unnatural way, sticking together. Think about it, normally there should be small joints between these bones, so that they can move freely. But in this case, new bone, cartilage, or fibrous tissue grows between those bones, connecting the two bones together. It's like a bridge is being formed.
Is this genetic? Or are there other reasons?
Most of the time, this condition called tarsal coalition is caused by genetic factors**. That is, it can be caused by a small abnormality in the development of the leg bones while the baby is still in the womb. That means it can also be hereditary.
But, it doesn't always have to be genetic. Sometimes,
- Due to an infection ,
- Due to a serious injury to the leg,
- Tarsal coalition can also occur in adulthood due to a medical condition such as arthritis .
Who is most affected by this situation?
Tarsal coalition is most commonly seen in children and young adults . Symptoms usually begin to appear between the ages of 9 and 16, as the abnormally joined bones become thicker, stiffer, and more painful.
However, some adults may also develop this condition for the first time, or it may have been present since childhood and not show symptoms, but may appear later.
It is said to be so common that it affects between 1% and 6% of the population. That doesn't mean it's that common. However, about half of people with this condition may have this problem in both feet (bilateral tarsal coalition).
What effects does Tarsal Coalition have on the body? What are the symptoms?
Not everyone with tarsal coalition has symptoms. Some people can live their entire lives without any pain or discomfort. So sometimes people don't even know they have it.
However, for those who do experience symptoms, they can range from a mild, intermittent pain to severe pain that is so severe that you can't walk . The main symptoms that can be seen are:
- Pain or stiffness below the ankle, in the middle of the leg, or in the back of the leg . As if the leg is stuck.
- Flat feet make it difficult to walk. This also increases the risk of ankle sprains.
- The pain may increase when exercising, running, or jumping. It may subside after a short rest, and then return when you become active again.
- Sometimes, these symptoms appear suddenly after a minor injury to the leg .
The time at which these symptoms appear varies from person to person. For some people, the pain begins at a young age, around 10-15 years old. For others, these symptoms appear only after they reach adulthood.
Are there types of tarsal coalition?
Yes, there are different types of this. That is, the types differ depending on where the abnormal bone joins together. The most common are:
- A connection is formed between the main bone in your ankle (talus bone) and the heel bone (calcaneus bone) .
- Or, a connection is formed between the heel bone (calcaneus bone) and the navicular bone in front of it .
These are the most commonly seen types. In addition, there are other types that are seen much less frequently.
How does a doctor diagnose this? (Diagnosis)
If you have leg pain, the first thing a doctor will do is examine your leg and ankle carefully. They will ask you questions about where it hurts, how it hurts, and when it hurts.
Then, to confirm the diagnosis, they will order several special imaging tests . These are:
- X-rays: These can give you a rough idea of the bones in your leg. Sometimes this abnormal connection can be clearly seen on an X-ray.
- CT scan (computed tomography scans): This gives a much more detailed picture than an X-ray. A CT scan is often used to diagnose tarsal coalition. It can show the relationship between the bones very clearly.
- MRI (Magnetic Resonance Imaging): While X-rays and CT scans mainly show bone, an MRI can provide a good picture of the soft tissues around the bone. Sometimes this test may also be necessary.
Remember, a doctor is the one who decides which of these tests you need.
What are the treatments for this?
The best thing is that a tarsal coalition only requires treatment if it causes symptoms . If there is no pain or discomfort, treatment is usually not required.
If symptoms are present, either non-surgical or surgical treatment may be recommended, depending on the severity of the condition.
Non-surgical treatments
The first step is to try to control this pain without surgery.
- Rest: Temporarily stopping activities that increase pain (such as running, jumping) can reduce the pressure on the bones and reduce pain. Usually, you will be told to rest for about 3 to 6 weeks.
- Injections: Sometimes steroid injections can be given to reduce pain. These are injected directly into the painful joint.
- Orthotics: Shoe inserts and arch supports can help stabilize your feet and reduce pain. These are custom-made to fit your feet.
- Boot or cast immobilization: A temporary boot or plaster of Paris (POP) cast may be used to immobilize the leg and reduce additional pressure on the tarsal bones.
- Losing weight: If your pain increases as your body weight increases, talk to a doctor and develop a weight loss plan that works for you.
Surgical treatments
If non-surgical treatments fail to control the pain, or if the condition is severe, a doctor may recommend surgery.
- Resection: This is the most common surgery for tarsal coalition. It involves removing the abnormally joined bone (coalition) and replacing it with tissue or muscle taken from another part of your body. Most people can regain normal function in their leg after this surgery.
- Fusion: If the condition is very serious, or if the joint is damaged due to things like arthritis, a surgery called fusion may be performed. This involves permanently connecting the affected bones together, limiting movement. This may involve using screws, staples, or metal plates . This helps keep the bones in a better position and reduces pain.
What happens if left untreated?
For some people, the pain and discomfort can be so severe that it can prevent them from doing activities they enjoy (like playing or walking). If left untreated, over time, the foot can become stiffer and more difficult to walk. So it's best to see a doctor if you have symptoms.
Can complications occur after surgery?
As with any surgery, there are risks involved. Some of the complications that can occur after tarsal coalition surgery include:
- Infection
- Blood clot (Hematoma)
- Poor wound healing
- Poor bone healing
- Nerve injury
- Blood clot in blood vessels
- Change in the shape of the toes (Flail toes or hammertoes)
- Stiffness or weakness in your toes
But don't worry, doctors are doing their best to minimize these risks.
Things to remember when living with Tarsal Coalition
If you have this condition, at the first sign of symptoms, stop any activity that could be causing them. Most of the time, rest is enough. But if the pain persists, see a doctor. He or she may recommend injections or orthotics to help control your discomfort.
How long does it take to recover from surgery?
Recovery time varies from person to person. Typically, it takes between 6 and 12 months to fully recover from tarsal coalition surgery. However, this time may be longer depending on your age, the severity of the condition, and whether you have other conditions, such as arthritis. The best way to recover quickly is to follow your doctor's instructions exactly.
Is there a way to prevent this?
Tarsal coalition is often genetic, so it cannot be completely prevented . However, if symptoms do occur, they can be managed properly. Early diagnosis and appropriate treatment can help prevent the condition from getting worse.
What should we expect if there is a tarsal coalition?
Although many people have this condition, symptoms appear in childhood or adolescence. Some people may never have symptoms. Therefore, not everyone with this condition is the same.
Can I play sports?
Playing sports can be a bit challenging for people with tarsal coalition. However, it is not impossible to play sports . If a doctor has confirmed that you have this condition, ask your doctor about what sports you can and cannot do, and what restrictions you should have. You may be able to do low-impact sports (like swimming).
The most important thing you have to say
The pain caused by tarsal coalition can be really annoying, sometimes to the point where it can affect your daily activities. Sometimes it takes a while to recognize it. But, fortunately, there are good ways to recognize it and treat it. These treatments can help control your symptoms and improve your quality of life.
If you or your child has persistent pain or stiffness in their legs, don't ignore it, see a doctor immediately for advice. Then, a treatment plan can be developed that is right for you. Don't worry, with proper medical advice, this condition can be managed well!
` Tarsal Collision, Foot Pain, Ankle Pain, Flat Feet, Pediatric Foot Diseases, Bone Connections, Surgery
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