Tarsal Coalition/ broken foot

Foot,

The tarsal coalitions of the calcaneonavicular and talonavicular are the most common. They are frequent causes of ankle sprains in adolescents, because the tarsal bones don't move separately, becoming a long-arm bar, thus causing the ankle to sprain. The coalitions also frequently cause flatfoot and used to be called peroneal spastic flatfoot. So, most coalitions are picked up during adolescence and treated then.

The long term effects of a coalition in an adult are in two categories. One, is where the person doesn't know they even have a coalition, and as a result have no problems. There is a subset of this category, where the coalition is picked up incidentally, and the person has no problems. The other category is where the person is having foot problems and the coalition is then discovered. Usually in adults, resection of the coalition is not an option, due to degenerative changes, so the patient ends up having fusions of other joints in the hind and midfoot.

There is not much in the literature about fracturing through a coalition. Since you were not having problems with your feet before the injury (you did not mention it at least), giving the coalition a chance to heal is probably the best option at the start. If it heals and you return to your previous status, that sounds like a winner.

If it heals and you develop problems, then you are in the category of patients who develop problems with their coalition. And you go from there.

If it does not heal, then your surgeons may have to get creative, as the literature doesn't really give any tried and true remedies. Do you resect the nonunion of the coalition and treat it as you would an adolescent or do you perform arthrodeses as you would in an adult?


As for the small fracture off the cuboid, if it is a small chip or fleck, it is usually where one of the many ligaments attaches. So, the ligament got pulled off the bone, essentially being a really bad sprain. These injuries can sometimes take a while to heal.


Your toes are going to be blue for quite awhile. The blood and edema is going to travel by gravity to the lowest part of the body, which is your toes. If you could manage strict elevation, you could see the blueness in the heel or even in the leg. It just goes to the most dependent part of the body. And bone is a living tissue, with a lot of blood. Remember that the bone marrow is where the blood cells are created.


So, you are sort of in unknown territory. There just isn't that much written about fractures through a tarsal coalition. If you are not being seen by an orthopedic foot and ankle specialist, you might want to seek out one, for an evaluation.

Good luck.