Paediatric and adolescent foot disorders
Maneesh Bhatia in Essentials of Foot and Ankle Surgery, 2021
Tarsal coalition is an abnormal connection between two or more tarsal bones. The majority are congenital resulting from mesenchymal segmentation failure during fetal development of the tarsal bones. An autosomal dominant inheritance pattern with a high penetrance has been suggested (89–94). The bridging may be fibrous (syndesmosis), cartilaginous (synchondrosis), or osseous (synostosis). It is generally estimated to affect 1–2% of the population; however, recent radiological and cadaveric studies described an incidence of up to 13%. Coalitions are bilateral in approximately 50% of cases with no sex predilection. The talocalcaneal coalition (TCC), primarily at the middle facet, and the calcaneonavicular coalition (CNC), between the anterior process of the calcaneus and the navicular, equally account for more than 90% of all cases. It can occur infrequently in any other 2 adjacent bones of the foot (95–100).
Congenital and Developmental Abnormalities
Harry Griffiths in Musculoskeletal Radiology, 2008
Although first described in the 18th century, it was not until the advent of X rays that tarsal coalition could be properly characterized. A number of clinical situations alert the orthopedist to the presence of tarsal coalition, and these include peroneal spastic flatfoot and painful rigid flatfoot. Many of the patients with this condition walk with a characteristic in-toeing gait. It is now thought that tarsal coalition is an inherited, autosomal dominant disorder. The overall incidence of tarsal coalition is 1% of the population, and in 60% of these patients, it is bilateral. The two commonest coalitions are talocalcaneal, classically involving the middle facet (48%) and calcaneonavicular (44%). The remainder is rare.
Tarsal Coalition
Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel in Essential Paediatric Orthopaedic Decision Making, 2022
She walked with an antalgic gait. The medial longitudinal arch was lower on the leftside than on the right. When she stood on tip toes, her leftheel did not swing into varus, and the arch did not get restored as much as on the right (Figure 42.1a). The gastroc-soleus was mildly tight, and passive motion of the subtalar joint was reduced. Tenderness was elicited just anterior to the lateral malleolus. Rapid inversion of the forefoot produced pain and demonstrable spasm of the peroneal muscles (Figure 42.1b). A provisional diagnosis of a tarsal coalition was made.
Proximal interphalangeal-level fracture in patient with symphalangism
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Tommy Pan, Don Hoang, Alexander Payatakes
Symphalangism is often associated with other skeletal abnormalities such as camptodactyly, clinodactyly, syndactyly, radiohumeral fusion, pes planus, bilateral hip dislocation, tarsal coalition, and congenital fusion of the cervical or thoracic spine [10]. The fused phalanges result in diminished hand function with inability to make a fist and difficulty performing fine movements. Associated findings may include absence of cutaneous creases over the affected joints and conductive hearing loss [8].
Related Knowledge Centers
- Antalgic Gait
- Cartilage
- Malleolus
- Navicular Bone
- Synostosis
- Tissue
- Tarsus
- Calcaneus
- Talus Bone
- Sinus Tarsi