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What Is Tarsal Coalition Resection?

Tarsal coalition resection is surgery that removes an abnormal bridge of bone, cartilage, or fibrous tissue connecting two tarsal bones in the foot. The procedure is most commonly used for symptomatic calcaneonavicular or talocalcaneal coalitions. Removing the coalition aims to restore motion between the involved bones and reduce pain. Tissue such as fat, muscle, or another interposition material can be placed in the gap to reduce the chance of the coalition reforming.

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What Is Tarsal Coalition Resection?

Tarsal coalition resection is surgery that removes an abnormal bridge of bone, cartilage, or fibrous tissue connecting two tarsal bones in the foot. The procedure is most commonly used for symptomatic calcaneonavicular or talocalcaneal coalitions. Removing the coalition aims to restore motion between the involved bones and reduce pain. Tissue such as fat, muscle, or another interposition material can be placed in the gap to reduce the chance of the coalition reforming.

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Why Is Tarsal Coalition Resection Performed?

Resection is considered when a symptomatic tarsal coalition continues to cause pain, stiffness, recurrent sprains, or activity limitations despite nonsurgical treatment. It is generally most suitable when the involved joint still has useful motion and does not have advanced arthritis. Hindfoot alignment, coalition size and location, age, and the condition of nearby joints influence the surgical plan. Patients with severe arthritis, rigid deformity, or poor joint preservation can require arthrodesis instead of resection.

How Is Tarsal Coalition Resection Performed?

The surgeon reaches the coalition through an incision selected for its location and removes the abnormal bridge while protecting nearby nerves, tendons, and normal joint surfaces. The remaining bone edges are shaped until the coalition no longer blocks the intended motion. An interposition graft or material can be placed between the resected surfaces to discourage reformation. Additional correction of a significant flatfoot or hindfoot deformity can be performed during the same operation when needed.

What Is Recovery Like After Tarsal Coalition Resection?

The foot is protected in a cast, splint, boot, or postoperative shoe while the incision and deeper tissues begin to heal. Weight-bearing instructions vary with the coalition, surgical approach, and any additional procedures. Range-of-motion exercises and physical therapy are introduced gradually to restore foot and ankle mobility, strength, and gait. Return to sports or higher-impact activity occurs after pain, motion, strength, and healing have progressed adequately.

What Are the Risks and Complications?

Possible complications include infection, wound problems, nerve irritation, stiffness, persistent pain, and incomplete restoration of motion. The coalition can recur through bone or scar formation across the resection site. Residual flatfoot, hindfoot malalignment, or preexisting arthritis can continue to cause symptoms even after successful resection. Some patients later require repeat resection, deformity correction, or joint fusion.

Frequently Asked Questions About Tarsal Coalition Resection

What is removed during tarsal coalition resection?

The surgeon removes the abnormal bridge connecting two tarsal bones. The coalition can be made of bone, cartilage, fibrous tissue, or a combination of these tissues.

Why is tissue placed between the bones after coalition resection?

Fat, muscle, or another interposition material can be placed in the resection gap to reduce the chance that bone or scar tissue will reconnect the bones.

Does every tarsal coalition need surgery?

No. Many patients can be treated with activity changes, immobilization, orthoses, medication, or physical therapy. Surgery is considered for persistent symptomatic cases.

Can a tarsal coalition grow back after resection?

Yes. Reossification or scar-related recurrence can occur and can cause renewed pain or stiffness. Interposition techniques are used partly to reduce this risk.

References

Tarsal Coalition Symptoms & Causes. FootCareMD, American Orthopaedic Foot & Ankle Society. https://www.footcaremd.org/foot-and-ankle-conditions/midfoot/tarsal-coalition. Date Accessed August 13, 2026.

Tarsal Coalition. OrthoInfo, American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/tarsal-coalition/. Date Accessed August 13, 2026.

Outcomes of surgical management for tarsal coalitions: a systematic review and meta-analysis. PubMed. https://pubmed.ncbi.nlm.nih.gov/37462747/. Date Accessed August 13, 2026.

8 out of 10 patients do well after surgery for tarsal coalitions: a systematic review on 1284 coalitions. PubMed. https://pubmed.ncbi.nlm.nih.gov/35397990/. Date Accessed August 13, 2026.

Calcaneonavicular coalition: treatment by excision and fat graft. PubMed. https://pubmed.ncbi.nlm.nih.gov/19568010/. Date Accessed August 13, 2026.