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Tarsal Coalition

A followup of adolescent athletes

Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts

Lyle J. Micheli, MD

Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts

A retrospective review was undertaken of 16 adoles cent patients (20 feet) with tarsal coalitions. All patients were active in sports and were seen in the Sports Medicine Clinic. Ages ranged from 9 to 17 years (av erage, 13 years). Failing conservative therapy, 18 feet had resection of the tarsal bar; 1 patient (2 feet) had bilateral extraarticular subtalar arthrodeses. The pa tients were seen in followup an average of 5.1 years postoperatively (range, 2 to 10 years).

An objective ankle/foot score was developed and all patients improved their score postoperatively, with the average score being improved 25%. Nineteen of 20 feet (95%) had excellent or good postoperative results by the ankle/foot score, while 17 of 20 (85%) had an excellent or good subjective result.

Two bars in two feet (10%), both in the same patient, recurred. There were six patients with preoperative talar beaking, and all had an excellent or good follow up result. All males returned to their previous level of competition in sports, while three female patients (three feet) gave up sports.

Resection of tarsal coalitions, even in the presence of talar beaking without other degenerative changes, yields consistently good follow-up results.