# tarsal coalition



## happymom7 (Jan 14, 2010)

Hello ~ I just found out my son has tarsal coalition (bone fusion of the foot). I don't know any one to talk to about this because it is sorta rare. I would really like to connect with moms out there who has been through this. He is scheduled for surgery, which I don't like but he is limping and having pain. Please connect with me if you can relate.

Much Love


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## ljc (Oct 14, 2008)

happymom7,

I have no BTDT experience. But, I do have a 7 year old son who was just diagnosed with a calcaneal tarsal coalition. He injured his foot this spring and was never able to completely recover. He continued to limp and will admit it is "sore" if asked. We have been to a local ortho and to a pedi ortho at Boston Childrens Hospital. We will see one of the doctors there this month that is a foot specialist.

How old is your son? When is surgery scheduled for your son? I would love to keep in touch and know how you are both doing. I don't know anyone else with this condition. My husband and I are both Physical Therapists, but I have never had a patient with this diagnosis.

Take Care

LJC


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## happymom7 (Jan 14, 2010)

Thanks so much for responding! The doctor wanted to do an excision of a calcaneonavicular coalition. He was scheduled for surgery on Aug. 10, but I postponed it to try a more conservative approach. He has been working with a chiropractor seeing if that helps. My son is 11. I have met a few people through a facebook support group who have tarsal coalition, but other than that I don't know anyone else with this condition either. I would love to keep in touch with you also. I think it is great you are Physical Therapist because at least you understand more about the anatomy of the foot than I do. My son's limp has gotten better through working with the chiropractor. He is wearing a splint at night when he sleeps. He is also doing exercises to help with the condition. My son has tarsal coalition in one foot and his other foot is flat, so we are also working with that.

Please keep in touch!

Many thanks


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## happymom7 (Jan 14, 2010)

LJC,

I was wondering if you could give me some input. I was taking my son to a chiropractor to see if we could avoid surgery. I have been doing it for 3 weeks. There has been some improvement, but he is still limping. I took him to a pcp on Friday and he suggested that I take him to a PT instead of a chiropractor. Do you think that PT could help this condition or do you think it is just something where surgery is the best option? I would really appreciate your input, because I have read the longer you wait the more arthritis can set in. Being you are a PT, I would love to hear what your think of this.

Many thanks,

Paula


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## ljc (Oct 14, 2008)

HI Paula,

Sorry I haven't responded - haven't been here for a few days. I should tell you that in my practice I treat mostly adults and have never had a patient with this diagnosis. Nor have any of my colleagues. So I too am thinking this through and learning as I go. Though I do have an understanding of the anatomy and biomechanics.

There are times that I refer to chiro and I have used chiro in the past myself. However, in this instance I wouldn't imagine it would help. This is what I consider a "fixed deformity" - meaning there is nothing short of surgery that will change the fact that the bones are fused. Therefore the joint can not be manipulated. I wouldn't think manipulating the surrounding joints would be helpful as they are likely hypermobile to compensate for the fusion.

PT might help if he has significant muscle shortening and or weakness. My son does not have either tightness or weakness. My son does also limp, but complains only of minimal pain. The other thing that might help is a custom (or off the shelf) arch support. I believe this is how they conservatively manage the condition.

I would love to conservatively manage this with my son and I think that the Children's Hospital in Boston will if they can. However, my concern as a PT is that the "limp" or gait deviation will lead to excess wear and tear on the other joints. I guess you can think of it like a car that is need of an alignment with asymetrical wear on the tires. Don't get me wrong we are not all perfectly symetrical people, but when people have a "significant" deviation from the normal in bony alignment they will get premature arthritis in surrounding joints. So I guess the million dollar question is how and when to decide when surgery is indicated. Does your son complain of any lower extremity or back pain? My son does not but I worry that waiting for significant pain will be an indication that he is already abusing other joints. How active is your son? My sons is very active and gets great enjoyment from the sports he participates in.

We will be seeing the foot specialist on August 26th and I will let you know what I learn after that visit. What does your ortho doc recommend? Do you have confidence in his/her skills and recommendations?

Lets keep in touch

Laurie


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## happymom7 (Jan 14, 2010)

Hi Laurie,

I just wanted to update you on how things are going. His PCP recommended him to a PT to help with tight hamstrings and to work on a conservative treatment before trying surgery. He said he would like him to do at least 3 months of PT. They are all working together on a conservative method first. They had told me that sometimes the tarsal coalition will break on its own. I am not sure if this is a good thing or a likely thing. Anyway, I just wanted to let you know how things are going. Please keep me updated on how things are going with you.

Take care


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## ljc (Oct 14, 2008)

Thanks Paula

Keep me posted. We are in a "boot" for one more week and will see one of the foot specialists at Boston Children's Hospital next Friday - I will let you know what I learn. Good luck with the PT!


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## happymom7 (Jan 14, 2010)

Hi Laurie,

We have decided to go ahead and give surgery a try. The physical therapist said it was best to go ahead and do the surgery. I am in the process of scheduling it. I just wanted to let you know how things were going for us. I would love to hear from you. How did the appointment go with the foot specialist?

Take care,

Paula


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## ljc (Oct 14, 2008)

Thanks Paula

My husband attended the visit with my son as I was out of town. The doctor gave him the statistics re pain resolution with and without surgery - 50% resolution without surgery and 75% resolution with surgery. Ok I wish those odds were a bit better. BUT my son doesn't complain of much pain. My worry is that he adjusts his gait and his movement patterns to avoid pain and/or because the mechanics of his foot demand the change. And I still find him limping even though he is not complaining. He was just coming out of a period of immobilization so she wanted us to follow up in another 3 months and let her know how he is doing. She did tell my husband that he was not too young to perform the surgery.

I also spoke with the orthotist that I respect and have worked with for many years. He has children on his caseload both pre and post surgical with this diagnosis. He told me that he would absolutely do the surgery if it was his child and sooner vs later. He feels like I do that this will just cause excessive wear and tear on other joints and that his outcome would be better earlier as his bones are still developing.

He is also going to fabricate an orthotic for Aidan's shoe next week to hopefully improve his gait in the meantime. The MD had little to say about orthotics and only suggested a supportive shoe. We are fortunate to have this friend and colleague to make us this orthotic as they can be very expensive and kids grow so fast. I will say that we've done our back to school shoe shopping and I convinced Aidan to purchase a pair of "running" type sneakers that had a bit of an arch. I think he does better in them. Maybe the shock absorption - Maybe the elevation under the heel.

Paula- I think you are making the right decision and my husband and I are going to push to do the surgery sooner vs later at our next visit - we may in fact move the visit up so that we can schedule this winter. As you know it's just so hard to make the decision to do an elective surgery on your child. As parents we question so many of our decisions.

We feel confident in our surgeon's skills - my only other advise is to be sure that this is a procedure that your surgeon does often. Surgical outcomes are so dependent on the skills of the surgeon - I see this in my office everyday.

Keep me posted I would love to know when your son has surgery so I can keep him in my thoughts.

Laurie


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## blnapril29 (Jan 1, 2012)

Hi Moms! I just found this thread... I would love to hear what is going on with your children.

My 10 (almost 11) year old son has T-C coalition in both feet.... no limp, but a bit of an awkward gait, terribly flat feet, but absolutely no pain..he is extremely active (hockey and lacrosse) although it is a bit painful to look at those flat feet!)

We have a good foot surgeon who specializes in pediatrics... the plan is to have both feet operated on this year... first foot is scheduled for February 9... resection of coalition, lengthening of calf tendon and possible lengthening of heal bone. Our goal is fix this completely.... but boy it is hard to accept putting my little guy through this...

Hope your kids are doing well!


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## marimorr (Jan 3, 2012)

I wish I found this site before... it would have been great to hear from others, too.

My son had surgery for calcaneonavicular tarsal coalition in November. He had the surgery done in his right foot and will have the left done in the spring. He is 11 and is very active in football and other sports. I had to pull him out because the pain was so bad before he was diagnosed.

He was originally told by a horrible podiatrist that his problem was flat feet and that he should be fine. This went on for 2 years and he had custom orthotics.

I finally got a second opinion and confirmed that something was indeed wrong with his feet. Poor kid had been playing in pain for 3 years!

The surgery went well for the first foot. He was on crutches and a cast for about 4 weeks and used crutches for another week. He is still walking with a bit of a limp, but he says the operated one is now his good foot. The other one bothers him now! So far I think it was a great decision. We found a doctor that we trust and he can't wait to get the other one done! He is glad he did the surgery and can totally feel the difference.


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## Tina Jurva (Jan 21, 2012)

I was researcing and found this site. My daughter could not walk for 4 months because of pain. We exhausted every docotor and settled on "chronic pain". She is now going through some tuff physical theapy to get her muscle tone back. We went to the hospital after Christmas to get all the doctors together and on board and to agree on one thing.

We did a follow up on Tue with a rheumatologist who found she had VERY flat feet and to go to a podiatrist. Well, now after 4 LONG months he has a strong suspision she has tarsal coalition.

I should have guessed because I have it as does my son. He is 18 and it has never bothered him~ lucky boy. They found his by acident during a sprain incident.

I am glad to read all your thoughts and would like some more and up dates. She is in so much pain and I am conflicted.

Mine never hurt but had surgery to poss. relieve the flat foot.


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## blnapril29 (Jan 1, 2012)

So glad to hear that surgery went well for your son. My son is scheduled for his first foot in 2 weeks... I am playing it cool with him, but I am getting nervous! If he were in pain, it would be easier to justify this...but he feels nothing. I do know that won't last...so I know we are doing the right thing... it is just so hard!

Can I ask some questions about the surgery... ?how long did it take ?was there a lot of pain post-op ?what about physical therapy....was it tough?

thanks for sharing your story!


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## ljc (Oct 14, 2008)

Hi Everyone - I don't check in often - very surprised to see a bunch of new folks on the thread.

My 8 year old son had surgery December 21 - so 7 weeks ago now. To answer some of the above questions. Surgery was aproximately 2 1/2 hours. He didn't complain of much pain. The worst part of the entire ordeal was his vomiting and nausea after surgery. He was so hungry - but so sick.

He had already learned how to walk on crutches (due to ankle injury last spring) - so he did fine on those and had all of Christmas break to recuperate before returning to school. Both his Dad and I are Physical Therapists so we are doing the therapy at home. He recovered his flexibility quickly and now we are working on strength and balance. He still runs with a limp and will at times walk with a limp too. There is still some swelling.

I can't wait to see him walk and run without a limp.


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## marimorr (Jan 3, 2012)

Binapril 29- Hope your son's surgery went well. My son's took about 2 1/2 hours. Pain after surgery wasn't too bad. He had pain pills to help. He was in a cast and he had to have it changed and looked at every week. I think he went through 4 of them. He had a button attached to the bottom of his foot holding the muscles in place in his foot. When that was ready to fall off, he was able to remove the cast.

He went right into a regular shoe and was so excited that he did too much and his ankle swelled up a bit. He had to miss another week of school due to the pain. My advice to you is when he gets the cast taken off, take it slowly.

He was much better after that. He has no pain with his fixed foot and the other one is scheduled in April.

He didn't do physical therapy. I was surpised, but the doctor said he didn't need it.

My son can't wait to get the other one done. We are hopeful that his feet won't hurt anymore.

I hope this helps.


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## Lynn Russell (Feb 20, 2012)

I am glad to have found this! My son has just been diagnosed with tarsal coalition after months of pain. He has severely pronated flat feet and now cannot move his one foot side to side and is in extreme pain. He also has Osgood-Slaughter's disease in that knee. He has grown very fast and is 13 and 6 feet tall with size 13 feet and still has growing to do!! I am working with an orthopedic surgeon who has never seen this before and is trying to find a specialist who has. I live in BC, Canada and hope we don't have to travel too far or wait too long. He is a very active kid involved in sports and his passion is Taekwondo. I am not sure where to look to find a specialist who can correct this and would be grateful for any advice.

Thanks!!


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## Lynn Russell (Feb 20, 2012)

I am glad to have found this! My son has just been diagnosed with tarsal coalition after months of pain. He has severely pronated flat feet and now cannot move his one foot side to side and is in extreme pain. He also has Osgood-Slaughter's disease in that knee. He has grown very fast and is 13 and 6 feet tall with size 13 feet and still has growing to do!! I am working with an orthopedic surgeon who has never seen this before and is trying to find a specialist who has. I live in BC, Canada and hope we don't have to travel too far or wait too long. He is a very active kid involved in sports and his passion is Taekwondo. I am not sure where to look to find a specialist who can correct this and would be grateful for any advice.

Thanks!!


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## blnapril29 (Jan 1, 2012)

My son's surgery had to be postponed... he had a the cough and cold that is going around and he had too much chest congestion for "elective" surgery... he is all cleared up and is scheduled for tomorrow (Feb 22)....

Thanks for the posts about post-op... they made me feel a lot better (I had visions of him being in terrible pain)...

I will let you all know how it goes.


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## ljc (Oct 14, 2008)

thinking of you and your son today blnapril29


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## ljc (Oct 14, 2008)

Lynn - I hope you are able to find someone close by that is experienced in repairing coalitions - i am sorry i have no suggestions - we are on the east coast and had surgery at Boston

Childrens Hospital. Take the time to find an experienced surgeon - it can make all the difference. Good luck.


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## Lynn Russell (Feb 20, 2012)

Thanks so much. We just got word that a Dr is going to review my sons case and he is only 4 hours away. My only worry is that I need to know that he is THE ONE that will be right for this surgery. How did you come to get your dr? A referral? Do you know if there is any way for me to find out about this dr and see if he is any good?? Thanks again.

I wish good luck to the other kids going through this and their parents. Its so tough when you see your child in pain and cannot help them. Good luck to all!!!


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## ljc (Oct 14, 2008)

Quote:


> Originally Posted by *Lynn Russell*
> . How did you come to get your dr? A referral? Do you know if there is any way for me to find out about this dr and see if he is any good?? Thanks again.


Lynn- so happy to hear that you have a lead on a doctor. We are very fortunate to live only 75 miles from a top Children's Hospital. We worked our way from a local orthopedist to a lower extremity specialist at Children's Hospital and eventually on to Dr Spencer. She was one of the two MD's at Children's that specialized in feet. Much of her practice involved reconstructing severely deformed feet. So I felt confident that this was a "simple procedure" for her. I am glad we chose her because once they got into surgery they saw a much larger coalition than had been visualized on CTScan and my son had an "extra" muscle in his foot that had also started to scar down in the area. So she was able to handle all that - we ended up with a scar that was larger than expected - but we are doing great now.

I am a physical therapist - so I know from my own work that the skill of the surgeon can play a big roll in outcomes. There is actually research out now that outcomes are better when the surgeon has performed the procedure at least 80 times. (not on coalition excision specifically - but hip and knee surgeries). So one question you might ask is how often the MD performs this procedure. You might also ask if there were other parents who's children have had the surgery that are willing to speak to you. I am not sure about outcome studies in Canada.

Now with all that said - I believe in mothers intuition. So most important go with your gut.


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## Lynn Russell (Feb 20, 2012)

Thank you so much for the advice, I will keep you posted.


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## pmcpx4 (Apr 9, 2012)

Hi, I just found this site and everyone's posts were very informative. I am a 45 year-old female and I was recently diagnosed with Calcaneonavicular Coalition in my left foot by CT. It is indeed a childhood problem as I feel I must have been born with this but the injury to my ankle 6months ago brought this condition to the forefront. I am concerned as I think that this resection may turn into a fusion. Everything I have been reading indicates that the older you are increases the chances that arthritis has set in requiring a fusion. I had been in so much pain that I required a pain block in early March and unfortunately, it only lasted 3 days shy of a month. I am waiting for my call for the surgery. I will be seeing my Orthopedic Surgeon next week and I will discuss all the details during the visit. Wish me luck....


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## ljc (Oct 14, 2008)

good luck pmcpx4!

It is my understanding that is it best fixed when you are younger. I will keep my fingers crossed that you find some resolution to your pain.


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## talullah (Apr 13, 2012)

My son was recently diagnosed with calcaneonavicular coalition in both feet and we were thinking about having them both done at the same time so that he did not have to go through recovery twice. Would you say, as a PT, that this would be a good idea or not. He actually wants to get the surgery done and them go right back to school but, since the school year is almost over, I think he should wait the few more weeks. I think he just wants his friends to sign his cast lol. Do you think it is possible to go back to school shortly after?


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## pmcpx4 (Apr 9, 2012)

Thank you ljc, I am scheduled April 24th, so much to do to prepare for post surgery and have so much more to do, my son graduates from High school in June, just hope I am mobile by then. Keeping my fingers crossed.


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## ljc (Oct 14, 2008)

Hmm - to do one or both at the same time - tuff question??? Will the MD do both at same time? Our protocol was to be non - weight bearing for 4 weeks. With both at same time this would mean wheelchair for a month - so you have to think of your set up at home/school etc. I think this would be hard on a kid - not that 2 back to back surgeries are not. We only had to do one foot to do - so I've never thought about both at the same time.

As for school my son took a week off - we did it over vacation. I think in lots of ways doing it during the school year was easier - lots of sitting in class - riding the elevator - friends signing cast. We are very active and outdoorsy - live at the beach - summer would be more of a hardship for my son.

On a positive note - It was done late December and today I watched him run bases at baseball as if it never happened. In fact better than he has ever run


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## dfk1 (Jul 10, 2012)

I am so thankful that I found this thread. My son was diagnosed with tarsal coalition in both feet 6 yrs ago. He has had two surgeries on both feet and more cortisone shots than I can count. He was pain free for almost 10 months. In Feb of this yr his right foot started giving him trouble again and has progressively gotten worse. He has had cortisone shots in that foot 3 times in the last 4 months that have not done anything for the pain. The Dr has done XRays several times and assures us that the surgery sites are doing very well. He has scheduled a MRI for this Thurs to see if that will show him something he may be missing. My son is now in so much pain he is back in his wheelchair. He graduated this year and is starting to college in the Fall. We were hoping this would all be behind him by the time he started to college. I feel so helpless. I have never met anyone else with this problem. Even though we have been dealing with it for so long I still don't understand it. I don't understand why there is not more that can be done for it. I am very interested to know if anyone's child has been pain free for any length of time after surgery.


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## ljc (Oct 14, 2008)

dfk1 - so sorry you are dealing with this - it's terrible to feel like you can't make things better for your son. my son is still doing great (ie no pain) surgery was in December. my son is quite a bit younger (8 years old). i feel lucky that we found his coalition accidently when he injured his foot. and we were able to fix it early on in his life.

my son had negative xrays and then an MRI that found the coalition. but my understanding is that the best way to look at things is with a CTScan. do you feel comfortable with your MD? don't be afraid to get a second opinion. we saw an amazing MD at Childrens Hospital Boston. I'm not sure where you live - but take the time to find the best MD you can.

i wouldn't keep injecting his feet if he is getting minimal to no relief - but you might consider custom orthoics to support his arches, wearing good supportive shoes, keeping body weight low, etc.

i hope you find the answers you are looking for soon. best of luck.


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## msgo (Aug 1, 2012)

So glad to have found this thread. We noticed in kindergarten that my son walked and ran differently but were put off on it until age 9. He has pain when running, or jumping, occasional spasms, but no limping or constant pain. Our 1st opinion doc did x-rays and said no problems, wear inserts. After a year, we've gotten a 2nd opinion and this doctor says from x-ray he suspects coalition. We had the MRI and I was able to pick up our results today. It just says No Abnormalities demonstrated. I am confused as to how X-ray could show a coalition but MRI not show it?? I am frustrated. Were your children's coalitions diagnosed by XR or MRI? Of course, the foot doctor may read the MRI himself before our appointment next week, and I thought maybe he wanted to MRI to check the ligaments more than the bones... I don't know. I would just love a clear answer so we can get this resolved. What would you do? Thanks


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## ljc (Oct 14, 2008)

We were diagnosed with MRI. My son later needed a CTScan - I was told this was the best way to see it. After surgery we were told the coalition was even bigger than the CTScan showed. My son was age 7 at the time. His coalition was fibrocartilage when diagnosed. I suspect it would have ossified as he aged and would have been better visible on XRay. XRay shows bone. MRI does show the ligaments and tendons, but also cartilage. CTScan is not with risk/radiation exposure.

You will know more when the MD reads the MRI. I would make sure you consult with a *pediatric* *ortho* MD. When you say foot doctor you don't mean podiatrist do you?


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## blnapril29 (Jan 1, 2012)

I can greatly appreciate what you (and others reading this thread) are going through...

I am certainly no expert but am happy to share my son's story...maybe it will help someone:

My son is very active - has been playing ice hockey since age 5... and baseball/lacrosse during off season.

Spring/Summer of 2011 started to notice very flat, turned-out feet in my then-10year old son. Never any pain, no sprains....just flat, splayed out feet

Brought him to doctor in the Fall- thinking he would be getting orthotics....doc sent us for MRI ...diagnosis T-C coalition in both feet (not yet ossified, no arthritis)...

Doc recommended surgery...and after exhaustive research, I agreed... the coalition was obvious..

First foot was operated on Feb 23, 2012 Post -op course of treatment: 5 weeks in a non-weight bearing cast followed by about 2 weeks in a walking boot. PT began when out of cast....

Second surgery was done June 1, 2012... same post-op plan.

We were VERY careful after surgery - very little movement (he slept on couch so he would not have to go up stairs at all for the first week, used a wheel chair so there was no chance of slipping with crutches, even used a hospital potty so he would not go all the way to the bathroom .... fortunately, we home-school, so he was able to keep up with school work right from the couch).....

We were told to expect some pain after surgery...but there was very little - my son did not take any pain med's post op (again - he really did not move much at all...but we wanted to do everything we could to avoid needing pain meds)...the only time he took the Rx motrin was before he went in to have the cast and stitches removed at 3 weeks post op..

He is now at 25 weeks since the first surgery and is doing great.... PT is just about over... still walking a bit stiffly, but no pain...he was outside playing basketball with his friend today! He will be back on the ice in about a week.

I told the doctor when this started that he had 26 weeks to fix my son's feet...and we have just about made it!

Hope this helps! Good luck!


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## msgo (Aug 1, 2012)

Yes, this was a regular podiatrist we saw. I am taking him to see a pediatric ortho doctor too, but we have not had that appointment yet. We started with podiatry at our pediatrician's recommendation. The MRI reading came back normal in every way, which doesn't make any sense to me, since obviously something isn't right with his feet, unless maybe something is off higher up, like hips or knees. The podiatrist recommended orthotic shoes for a few years, then re-evaluate. I want him to be able to run and play, so waiting a few years isn't really what I wanted to hear, since we told that when he was in kindergarten and he hasn't gotten better. I wasn't sure how far we'd have to travel to see a pediatric doctor, but I found one pretty close! Hoping to get in to see him next week. I'll update then! Do you think they will re-read his XR and MRI or order more tests, or what?


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## ljc (Oct 14, 2008)

msgo - I hope you find the answers you are looking for - i assume the pedi ortho will be better able to answer your questions. keep us posted.


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## cindylew117 (Sep 14, 2012)

Hi my son had been diagnosed with tarsal coalition at Mass General. I'm really not happy with the direction they went in. I am going to call Boston Children's but we have a short window since he is now 18, and you can only go there till you are 19. He is in so much pain, and it was discovered after he had to quit lacrosse, which he loves, now he works in retail, as well as attending his senior year in high school. He is really active, and has a very high tolerance for pain. I'm so nervous that he's messing up his body by continuing to shift his weight of his bad ankle. Any suggestions on specific Dr's at Children's? Thanks so much. Also did any of your children walk later then usual. My son didn't walk till he was 15 months. I thought this was normal since he was the third, and my daughter carried him everywhere, now I wonder.

Cindy


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## msgo (Aug 1, 2012)

I don't have any great advice on doctors, but I did want to respond. I think at his age, a pediatric or regular orthopaedic surgeon would be fine though. My son was not a late walker, but we also do not have a confirmed coalition diagnosis yet. Best regards


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## ljc (Oct 14, 2008)

Sorry I didn't see this sooner. We saw Dr Spencer at Children's. I can't say enough good about her. Good Luck. My son was not a late walker (10 months). But always had a "funny" gait pattern when running.


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## Lissy123 (Sep 19, 2012)

Hi I looked online for 'supports groups' for people with Tarsal Coalition, and found this site. It's a mothering site but I have no children..I'm 19 and I was diagnosed with talocalcaneal tarsal coalition over the summer. It's weird that it would only start bothering me now, but it is what it is I suppose. I tried wearing an air cast and orthopedic inserts, even had laser therapy, but when I went back to college the distance I was walking stunted the recovery process. I started using a cane a week ago because of the pain..now I have a walking boot. I'm in PT for the ligaments on the bottom of the foot that is effected. My arch collasped causing the damage. I'm in pain all the time and can't take anything for it because the naxproxen I was taking gave me ulcers that I am now being treated for. I want to try all the conservative options first if anyone has suggestions for other treatments I could try please let me know


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## ljc (Oct 14, 2008)

Lissy 123,

So sorry you are having so much pain. I can't think of any other conservative approaches. Sounds like you have tried many. My son did not have a positive response to conservative treatment. With the exception of orthotics providing some pain relief. He did have a positive response to surgery, but was much younger at the time.

Hope you find relief.

Laurie


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## dawniedawn (Sep 27, 2012)

I am in a similar position in that I have no children but do have tarsal coalition myself. All I can say is try and do what ever it takes to get it sorted early. It took 8 years of doctors, physio, chiropodists, injections and scans before I was diagnosed at 33. I had an op which didnt work and now I have back pain, arthritis in my knees and still pain in my ankles. The earlier you can sort this the better


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## NZClaire (Dec 15, 2012)

Hi my 11 year old son had tarsal coalition surgery on both feet 2 days ago. He hasn't got any casts or boots on them, just crepe bandages and padding after surgery, these were changed to light dressings today. He has to keep his feet elevated for 4 days but after that will be encouraged to swim daily and weight bear as much as he is happy with. He is already trying his crutches out for short periods and took 8 steps today. He is on ibruprofen and paracetamol but has not needed much today. Full recovery is expected in around 6 weeks. We are in New Zealand and it seems that the procedure is very different here.


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## NZClaire (Dec 15, 2012)

Hi We are now 4 weeks post surgery and my son is swimming, running and cycling as normal. No limp whatsoever. If it wasn't for 10cm scars on each foot you wouldn't have known that he had had anything done. His feet are also slightly flatter than before.

Apart from swimming he kept his feet up for the first 2 weeks, rotating and stretching them every half hour or so and after that was allowed to walk as much as he wanted. We used a wheelchair for the first 3 weeks and he has walked without any support since then.

My surgeon can't understand why you would immobilise the feet when the last thing that you would want is for the bones to heal together. He says he never put any sort of cast or moon boot on tarsal coalitions patients are they usually fully mobile again within 6 weeks.

I was really glad I paid to get the operation done as soon as possible, although after reading lots of comments on forums I was very apprehensive. It turned out to be less painful and a faster recovery than a broken ankle. The cost over here was $8200NZ

My advice would be to get it done asap!


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## Vendula (Jul 24, 2013)

Hello, my 11 year old daughter was diagnosed with Talocalcaneal tarsal coalition in right foot two months ago. She has some pain and limited flexibility in her foot(side motion). She is high level gymnast and spends over 20 hours a week training. Doctor wants to just wait and see if steroid shots will help. We are trying to get another opinion, but it seems hard to find foot/ankle specialist. We live in California.
I am very glad I found this site, would love to hear from people that had the surgery done and how their kids are doing?


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## NZClaire (Dec 15, 2012)

Hi

Our advice would be to get it don*e as soon as possible*. The longer you leave it the higher the chance of long term problems caused by arthritic changes to the other bones in the foot. My son broke his 5th metatarsal a few weeks ago so had to have X rays of his right foot. This meant that we got the opportunity to have a look at the bones that were operated on. They have healed beautifully and apparently now look no different to a normal foot.

My son loves being able to rotate his feet fully and is now swimming and running MUCH faster than before the operation. As the stiffness creeps up gradually he didn't realise just how limited his movement had become despite being a very active child participating in sporting activities everyday. He was only diagnosed due to having an injured foot that didn't respond to physio which meant that he was sent for X-Rays.

We got both feet done at once which meant that he was not really mobile for about 3 weeks but he was swimming 3 days after the operation and had suprisingly little pain which was controlled with normal over the counter medication. Keeping his feet up definitely helped to reduce swelling and aid recovery time

Steroid shots will improve the pain short term but will not make any difference long term. The longer you leave it the move fused the bones will become which means the worse the surgery will be.

If you want me to email you some photos of his feet my email address is [email protected]


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## Charm137 (Mar 9, 2015)

Hi my Poor daughter is having really tough time with her feet - i SEe these Posts are quiet OLd - there is hardly Anything on this condition - they want to fuse her feet x - how have u all got on ??


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## Lissy123 (Sep 19, 2012)

Charm137 said:


> Hi my Poor daughter is having really tough time with her feet - i SEe these Posts are quiet OLd - there is hardly Anything on this condition - they want to fuse her feet x - how have u all got on ??


Hi, I realize this site is intended for mother's to talk about their children having Tarsal Coalition but as I have yet to find any conversation group for suffers themselves of this condition I joined a year or two ago. I'm 22, and was diagnosed just two years ago. Usually it is discovered when you are young and at that time you are lucky as it can usually be surgically repaired. I am not a surgeon nor am I a doctor that being said this advice comes purely from what material I have read and the different doctors I have consulted with.

Getting the coalition separated is the best option, the idea is once separated that the bones can continue to grow in the correct way. Fusion is usually a result of a separation surgery failing, used as a last ditch effort when nothing else can be done. If your child is 12 or younger and they are suggesting fusion I would strongly suggest getting a second opinion.

Also a lot of the choices to be made with regards to surgery will undoubtedly be reflective of how severe the coalition is.

On a personal note, I was too old when I found out about my coalition to be recommended for separation surgery. My first two doctors informed me I would be in horrible pain for the rest of my life and that I could just take pain killers. Or I could get a fusion which meant I would have severely limited movement in that foot and definitely no chance of jogging again. None of my doctors recommended physical therapy. All of them told me it was a structural problem which could only be solved surgically. I pushed for the physical therapy option anyway. I worked for a year with a physical therapist building up the surrounding muscles to support my ankle and foot. Two years later I have been keeping up with the physical therapy on my own every week and am no longer in any pain. I cannot run, I cannot jump, I cannot jog. For now. But I hope at some point in the future if I continue to work hard on muscle strengthening that I will be able to. If I had gotten a fusion my chances of ever jogging or jumping would be very low to impossible. Also I wear orthotic inserts in all of my shoes and I have found this very helpful.

So in conclusion my advice is double check the fusion surgery recommendation, talk to physical therapists, and also try to access if there are any other problems besides the coalition. For example I found out I had developed plantar fasciitis from the coalition causing my arch to collapse. Such things are important to know about, because if the coalition is not so severe, then the real cause of the pain might be another cause that can be solved without surgery.

Sorry for my extremely long post! I wish you and your daughter all the best! Good luck!


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## TJO (Apr 12, 2018)

Hi. I know this post is old, but my daughter is 11 and scheduled for TC surgery on May 3rd at Mass General. I was wondering if you wouldn’t mind sharing with me how your children are doing a few years post surgery? I am nervous to get this done, but we have been dealing with this for a year and a half, have tried a boot, PT, and other non-surgical options with no relief. It has come to the point where she can’t even take a walk around the block without pain. I am reaching out to all of you because you have been through this with your own children. I am also wondering how quickly they were able to be active again after surgery?
Thanks in advance and I hope they are doing well!!


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## Mombury29! (Apr 13, 2018)

*6 years later*

TJO - 
I can appreciate your anxiety about your daughter's upcoming surgery....but I can tell you it was the best decision I ever made for my son.
He had both feet done (3 months apart when he was your daughter's age. Below is my post a few months after the second surgery.

He turns 17 next week and has never had any problems with his feet.
Following the surgery, he was fitted with custom inserts (casts were made of his feet).... these were expensive but worth it. He wore then all the time. He grew and had to have a second set made... but when he grew again he did not get another set (that was about 3 years ago)... he never has problems with his feet at all. Have not been back to the doctor for his feet.

The most important advice I can give you is to completely minimize your daughter's movements after surgery. You can see what we did in my post below. My son never took any pain medication . We went through a LOT of lego sets! but at 11 years it is easy to keep them entertained.

You are with a great hospital so rest assured that your daughter is in good hands!
Please feel free to reach out with any questions or concerns. Happy to share

POST FROM 2012
First foot was operated on Feb 23, 2012 Post -op course of treatment: 5 weeks in a non-weight bearing cast followed by about 2 weeks in a walking boot. PT began when out of cast....

Second surgery was done June 1, 2012... same post-op plan.

We were VERY careful after surgery - very little movement (he slept on couch so he would not have to go up stairs at all for the first week, used a wheel chair so there was no chance of slipping with crutches, even used a hospital potty so he would not go all the way to the bathroom .... fortunately, we home-school, so he was able to keep up with school work right from the couch).....

We were told to expect some pain after surgery...but there was very little - my son did not take any pain med's post op (again - he really did not move much at all...but we wanted to do everything we could to avoid needing pain meds)...the only time he took the Rx motrin was before he went in to have the cast and stitches removed at 3 weeks post op..

He is now at 25 weeks since the first surgery and is doing great.... PT is just about over... still walking a bit stiffly, but no pain...he was outside playing basketball with his friend today! He will be back on the ice in about a week.

I told the doctor when this started that he had 26 weeks to fix my son's feet...and we have just about made it![/COLOR]


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## LadyJ552 (Jun 24, 2018)

*Granddaughter diagnosed with TC in both feet*



TJO said:


> Hi. I know this post is old, but my daughter is 11 and scheduled for TC surgery on May 3rd at Mass General. I was wondering if you wouldn't mind sharing with me how your children are doing a few years post surgery? I am nervous to get this done, but we have been dealing with this for a year and a half, have tried a boot, PT, and other non-surgical options with no relief. It has come to the point where she can't even take a walk around the block without pain. I am reaching out to all of you because you have been through this with your own children. I am also wondering how quickly they were able to be active again after surgery?
> Thanks in advance and I hope they are doing well!!


My 10-year-old granddaughter was diagnosed with TC two days ago after suffering with foot/ankle pain for months. She had to drop out of ballet a few months ago and the TC is limiting her outdoor activities and sports. We live in Northern Virginia and she is seeing a podiatrist who works with adults and children and has performed this surgery many times. He has said it's important to operate before the foot finishes growing. I'd love to hear how the surgery went for your daughter. Does she have TC in both feet and if so, did you do one at a time? We are considering all of the options and would love to hear from you!


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## Ashted (Jul 28, 2018)

*Any Recommendations for Pre-Surgery & Recovery Physical Activity?*

My 11-year old son has been diagnosed with a TC in both feet. He is in severe pain therefore his physical activity is limited to short walks. We plan to schedule his first surgery for January 2019 with the second surgery to follow. I am very concerned about his inactivity and how it's affecting his physical and mental well-being. It seems like any movement in his feet causes pain so even low-impact activties such as cycling and swimming are difficult.

Could anyone share ideas for what pre-surgery phyical activities worked for your child? Also, any recommendations for how to keep his spirits up during recovery? I am feeling overwhelmed with the responsibiility of keeping him as active as possible pre-surgery as well as during his recovery. Any ideas or advice would be greatly appreciated.


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