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Current Concepts Review: Tarsal Coalition

A tarsal coalition occurs in approximately 1% of the population and often is an overlooked diagnosis when it presents in adults. Zuckerkand1,55 published the initial description of a talocalcaneal coalition in Germany in 1877. Anderson1 reported the presence of talonavicular coalitions in 1879, and Slomann47 introduced the 45-degree lateral oblique view of the foot to diagnose calcaneonavicular coalitions in 1921. Slomann47 also suggested the presence of an association between pes planus, hindfoot rigidity, and tarsal coalition. Badgley3 associated calcaneonavicular coalition with peroneal spastic flatfoot in 1927. Later, Harris and Beath22 linked peroneal spastic flatfoot with talocalcaneal coalition. Advancements in multiaxial imaging have enhanced our understanding of tarsal coalitions. Modern CT and MRI enable surgeons to characterize the extent of joint involvement, the composition and location of the coalition, and the degree of degenerative change of the affected and adjacent joints. This new information has influenced our clinical decision-making and treatment of tarsal coalitions. The purpose of this review is to discuss evidence-based recommendations for diagnosis, imaging, and treatment of tarsal coalitions in the pediatric and adult populations.