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Family Foot & Ankle

Talking Tarsal Coalition: Treatments for Limping Children

Nothing hurts more than seeing a child in pain. True, kids are normally a pretty resilient bunch, recovering quickly from injuries, but some cases need more attention. One such problem is tarsal coalition, which usually affects kids between 9-16 and can have them hobbling.

Tarsal condition occurs whenever two or more of the 7 bones that make up tarsal bones (located toward the back of the foot and including the heel) become connected or fused. This can lead to feet that are rigidly flat, painful, and restricted in terms of range of motion. Although usually present at birth, tarsal coalition is often not detected until the child is older and bones have become more rigid, around the early teens. Some cases may not be diagnosed until adulthood.

The good news is that not every case needs to be treated with surgery. In fact, we recommend fully exploring conservative options before considering a surgical procedure. While these treatments won’t “fix” a tarsal coalition, they may provide adequate symptom relief and allow your child to enjoy a full range of activities without pain.

Non-surgical options include medications or injections to fight pain and inflammation, as well as temporary immobilization (using a cast or boot) to give the feet adequate rest. Taking a 3-6 week break from potentially painful high-impact activities like sports can reduce stress and pain on the affected bones. After that, your child may need shoe inserts or custom orthotics to provided extra support, stabilization, or cushioning.

Physical therapy is also an important component of most conservative treatment regimens, and may include massage, ultrasound therapy, and range of motion exercises designed to improve flexibility and eliminate stiffness.

If these treatments prove insufficient, we may consider surgery. The type of procedure varies depending on the specific situation; most are “resection” procedures that simply remove the affected abnormal tissue and replace it with transplanted soft tissues (such as fat, or a tendon) to act as a “spacer.” More serious cases require permanent bone fusion.

If your child is hobbling, it’s important to bring them to see a specialist. At Family Foot and Ankle Center, we pride ourselves on providing the highest quality foot and ankle care to your whole family, at every age. To schedule an appointment, call us today at 888-689-3317. 

Dr. Cynthia Miller
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Dr. Cynthia Miller is a board certified podiatrist who has been established in the Cincinnati area since 2004.
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