The Coalition is Only Part of the Problem: Tarsal Coalitions and Deformity Correction

Tarsal coalitions are a common cause of painful rigid or progressive foot deformity in children and adolescents, yet successful treatment requires more than simply identifying and resecting the coalition. This presentation will review the clinical and imaging evaluation of tarsal coalitions, with emphasis on determining how coalition type, skeletal maturity, hindfoot alignment, associated flatfoot deformity, superstructural issues and degenerative changes influence treatment decisions. Surgical options will be discussed along a spectrum ranging from coalition resection alone to combined deformity correction and reconstructive procedures. Case-based examples will highlight practical decision-making, operative planning, and common pitfalls in the management of pediatric and adolescent tarsal coalitions.