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Tarsal Coalition
Talar Beak
General Considerations
/are 657 incidence8
Fusion o! t9o or more tarsal bones in the hind!oot 6talus and calcaneous8 or mid!oot 6cuboid:
na%icular and ( cunei!orms8
Most common coalitions 6;'7 o! total8 are
Calcaneous and na%icular 6calcaneona%icular8
Calcaneous and talus 6talona%icular8
Fusion ma be congenital or ac<uired
Congenital !orm is !amilial
Autosomal dominant 9ith near com=lete =enetrance
Bilateral *'7 o! time
More common in males than !emales
Ac<uired !orm ma be due to trauma: in!ection: arthritis: surger
Types
Com=lete coalition
Bon 6snostosis8
Incom=lete coalition
Cartilaginous 6snchondrosis8
Fibrous 6sndesmosis8
Clinical Findings
Most are asm=tomatic
"hen sm=tomatic: sm=toms begin in &
nd
decade o! li!e
$ain is most common sm=tom
Made 9orse b =hsical acti%it
/estricted range o! motion
Muscles s=asms
Imaging Findings
Con%entional radiogra=h o! the !oot is the stud o! !irst choice
Calcaneona%icular !usions should all be e%ident on a )*> internal obli<ue %ie9
Bridge is usuall !rom anterolateral as=ect o! calcaneous to dorsolateral as=ect o! na%icular
"ith !ibrous and cartilaginous coalition: the ?oints ma be narro9ed: sclerotic and irregular
3alocalcaneal coalition ma be more di!!icult to see
Most o!ten in%ol%es ?unction bet9een the middle !acet o! the talus and the sustentaculum talus
Talar beak =resumabl occurs because o! limitation o! motion in subtalar ?oint
At insertion o! talona%icular ligament: =eriosteal reaction de%elo=s
Bea# not =resent in all =atients 9ith talocalcaneal coalition
$es =lanus de!ormit is common
H=o=lasia o! the sustentaculum tali ma occur
M/I is most sensiti%e to !ibrous and cartilaginous !usion
Treatment
Conser%ati%e treatment is utili0ed !irst
NSAID 6non@steroidal anti@in!lammator drugs8
Steroid in?ections
Arthotics
Surgical inter%entions most commonl in%ol%e resection o! the bridge and =lacement o! !at: muscle or
tendon in =lace o! the coalition
Arthrodesis is sometimes used 9ith se%ere coalitions
Complications
Cause o! s=astic =eroneal !lat!oot
Bon bridge can !racture


Talar Beak and Tarsal Coalition. 3he 9hite arro9 =oints to a Btalar bea#B seen on the dorsum o! the talus
9hich should raise sus=icion !or the =resence o! a tarsal coalitionC 3he obli<ue %ie9 o! the same !oot
demonstrates bon bridging bet9een the tarsal na%icular and the calcaneousC
For additional in!ormation about this disease: clic# on this icon i! seen abo%eC
For this same photo without arrows, click here

Tarsal Coalition eMedicine Eric A Wang, MD, Amilcare Gentili, MD, Sulabha Masih, MD, and Matthew C Wang, BS