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Foot & Ankle Problems Message Board


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I posted a while back...newly diagnosed with tarsal coalition. I'm still new to this diagnosis, so please bear with me. I believe the coalition involves bone (versus soft tissue???).

Anyway, I am 31 years old. History of "loose" ligaments, tendons. Right ankle lateral ligament reconstruction in Jan 2006. Left knee ACL 10 years ago. Had a post tib tendonitis diagnosis for msot of this summer in left ankle, but that all changed with a follow up MRI in November where the tarsal coalition was found.

My ortho surgeon would like to try an excision. He says it is a "loose" coalition, not too much damage yet to the joint itself. He has never done an excision on "older" patients as most excisions are done on patients younger than 20. The recovery time is much less, less pain, etc., non-weightbearing for 2-3 wks (he's guessing as he's not done one on an "older" patient) and then 4 wks in a boot. The other option is a fusion, which I think there are many of you out there that have had the fusion done. The excision, if it works, would maintain hindfoot movement. The downside is that we just don't know if it will work nor for how long. It could be the "cure" and I won't need anything else, it could buy me some time or it might not work at all and then I would need the fusion.

I do have 2 younger children, one of which has some medical needs that require skilled care (for now, set for surgery here soon to hopefully address the last of the issues and live a healthy life). Anyway, I'd like to avoid the fusion if at all possible.

I should also mention that this became symptomatic when I started running after my ankle surgery in January. He didn't seem too thrilled with the idea of me continuing to run after a fusion (and I don't even know if that's physically possible), but it does seem like I would be able to eventually start running again after an excision.

I was just wondering if anyone else has had an excisionfor tarsal coalition and what recovery was like, if it worked, how old you were/are when it was done, just any info you can give me. He had mentioned the resection and fusion options at my last visit, so I had researched those, so this excision option took me by surprise.

Bottom line, the excision is questionable as to whether it will work, but he is preparing a good team and contacting who he needs to in order to form a surgical plan. He is skilled in fusions and has done many successfully.

Just wondering too if anyone else would be willing to be a "guinea pig" of sorts to avoid the big surgery? Although it could mean that I have 2 surgeries instead of one "big" one.

Any thoughts, opinions are appreciated. I'm looking to schedule the procedure in mid-January.

Thanks.
Jennie
First off, I am 23 and had an excision of an osseous calcaneonavicular coalition about 3 1/2 months ago. I had an incomplete coaltion, meaning it hadn't totally fused. Surgery was actually a last resort for me. They tried immobilization first, but I am on my feet all day every day and that didn't work for me. I was non-weightbearing for 2 weeks only, and then after 2 weeks I was placed in a cam walker and could weight bear as tolerated. I was only in the boot for 3 weeks before being allowed to ease into a shoe. Now, I'm still having foot problems, but that doesn't mean you would. I have extremely flat feet and being on my feet all day that really can aggravate things. I would definitely get a second opinion before undergoing any surgery. One dr. wanted to treat me with orthotics, after being in a boot with no improvement for months, then the other dr. i saw in the same group told me orthotics would be a waste of time if immobilization didn't work. I actually work for a large orthopaedic group, and I was told that I will continue to have pain for awhile due to my work. Long story short, recovery is different for everybody, i still have really bad, painful days, and i also have very good days with no pain. Would I recommend an excision over a fusion? Yes I would because you are still pretty young and if your only problem is a coalition, you should have a faster recovery with an excision. Even if you end up needing a fusion down the road, you would get a few extra years. Fusions are extensive surgeries, and being an x-ray tech for an orthopaedic practice, i've seen a lot of patients who get fusions that seem to still have quite a bit of trouble. I don't know if I have been much help, but I have had the surgery and for the most part the pain from the coalition is totally gone, now I'm just having some other issues that are just due to bad feet.





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