Progressive Foot Care

Talocalcaneal Coalition

In children ages twelve to sixteen a bridge between two bones in the rearfoot may occur, known as a talocalcaneal coalition.  This is an abnormal joining of the talus bone with the calcaneus bone. 

Below is an x-ray illustrating a talocalcaneal coalition:

Talocalcaneal Coalition

Common signs include a “halo effect” as the two bones are united.  There is also a flattening and broadening of the lateral aspect of the talus.  As well, there is a loss of clarity of the middle and posterior facets (articular surfaces) of the subtalar joint.  In some cases, there is a ball and socket appearance to the ankle joint.

Conservative treatment includes custom orthotics and bracing, as well as NSAIDs, below-knee casting, steroid injections, and physical therapy.  

Surgical correction includes fusion of three joints, known as a triple arthrodesis.  Other options include middle facet bridge resection, arthroeresis, subtalar joint fusion, Grice-Green extra-articular arthrodesis, and resection with extra-articular arthrodesis.

Success rates are rather high for the surgical approaches.  Early diagnosis and treatment is always preferred.

If your child suffers from foot pain, please make an appointment with the doctors of Progressive Foot Care for a comprehensive examination.