Hard Tissue Injury

Question 1

What is tarsal coalition ?

Answer 1

It is a genetically inherited disorder involving the abnormal connection of 2 or more tarsal bones.

Question 2

What are the 2 most common types of tarsal coalition ?

Answer 2

talo-calcaneal - between the talus and calcaneus
calcaneo-navicular - between the calcaneus and the navicular.

Question 3

What are the different types of coalition ?

Answer 3

They can be fibrous (tissue), cartilaginous (cartilage) or osseous(bone).

Question 4

What is the range of impact of tarsal coalition ?

Answer 4

Can have no impact on day to day life or can result in the inability to walk or bear weight on the foot.

Question 5

What is associated with tarsal coalition ?

Answer 5

The lack of an arch in the foot (flatfoot), spasms within the tendons of the foot, hindfoot valgus or forefoot abduction (foot deviations )

Question 6

What orthotics can treat tarsal coalition ?

Answer 6

Usually a combination of ankle braces and insoles.

Question 7

What qualities do the orthotics have ?

Answer 7

insoles - deep heel cup to lock patients foot into the anatomical position and prevent friction or shear forces.
high flanges to prevent any deviation or shear forces
ankle braces - provide rigidity to reduce plantar flexion (toe pointing downward) and increase area over which force occurs (decreasing pressure on pressure points)

Question 8

Biomechanics of tarsal coalition ?

Answer 8

Stability - unilateral coalition may reduce stability.
Tensile strength - may be reduce with excessive loading.
Lack of arch increases rigidity which in turn reduces the ability to absorb the compressive force.