Depending on how uncomfortable or painful the foot is, tarsal coalition treatment can be initiated with a cast, boot or a brace and then followed with orthotic arch supports. When symptoms from tarsal coalition begin, they can be quieted down by immobilizing the foot in a cast or a boot. This does not treat the underlying problem of the coalition but it does help temporarily with the symptoms of pain and soreness.
Occasionally, the use of a cast for a few months will be sufficient as treatment and once the cast is removed the symptoms dissipate. While the symptoms of the coalition may be improved, the coalition remains, and the foot continues to be stiff. For this reason, once a coalition is diagnosed, it is unusual that the use of the cast immobilization is the only form of treatment.
In order to completely eliminate tarsal coalition symptoms and improve the movement in the back of the foot, surgery is required. The surgery is designed to remove the tarsal coalition and improve the inversion and eversion movement of the foot. Once this is done, most children are able to resume full athletic activity.
There are times when removal of the tarsal coalition cannot completely correct the deformity. For these children, additional surgery may be necessary, particularly if the tarsal coalition is associated with a very flat foot. This is because simply removing the tarsal coalition will not correct the arch of the foot itself.