Tarsal coalition is a rare but often misdiagnosed cause of flat and painful feet in children and some adults. The main cause of pain is due to the bones of the foot not separating at birth resulting in stiffness and abnormal alignment.

Conservative care of a tarsal coalition may require the use of orthotics and stretching. If conservative care fails, surgical correction may be necessary.

Surgery of a tarsal coalition is based on realignment of the foot and removal of the coalition region. This is usually a very successful surgery in children. With time, there may be the development of arthritis in the surrounding joints or a tarsal coalition. In such a case, removal of the coalition will not relieve pain and it may be required to perform a fusion of the joints involved with realignment to relieve pain and correct the deformity.