A comparative study of the clinical presentation of tarsal coalitions.

Twenty patients have received the radiographic diagnosis of tarsal coalition. Seven were talocalcaneal (35 per cent), seven were calcaneonavicular (35 per cent), and six were talonavicular (30 per cent). The average age at time of diagnosis was 19.3 years for talocalcaneal coalition, 14.7 years for calcaneonavicular coalition, and 15.2 years for talonavicular coalition. Bilateral involvement was seen in more than half of the talocalcaneal and talonavicular coalitions. Symptoms were more severe in talocalcaneal and calcaneonavicular coalitions. All patients in these two groups had pain. Talonavicular coalitions either were asymptomatic (picked up on radiographs taken for other complaints) or were associated with painful medial navicular masses. In our study, five of the six patients (81 per cent) had this mass. We report a surprisingly high number of talonavicular coalitions for such a small group. In studies based on the investigation of peroneal spastic flatfoot, this form of coalition is not as frequently encountered. This suggests that talonavicular coalitions may be much more common than the literature to date has suggested.