Tarsal coalition in adults

32 feet in 27 adults, seen at The Johns Hopkins Hospital Foot and Ankle Cli nic from 1993-1998, with the diagnosis of tarsal coalition were retrospecti vely reviewed. There were 18 subtalar coalitions, 14 calcaneonavicular coal itions and 1 naviculocuneiform coalition. The average age was 40 years. Cli nically, 22 feet had a neutral heel, 7 had a valgus heel with flattening of the longitudinal arch, 1 had a varus heel and 2 heels had an unknown posit ion. Subtalar motion was decreased in 23 feet. Peroneal spasm was only seen in 2 patients. 11 feet were asymptomatic. Nonoperative treatment consisting of activity modification, nonsteroidal an ti-inflammatory medications and casting was successful in the majority of p atients. Subtalar fusion was performed in 4 feet and coalition resection in 1. The treatment of a symptomatic tarsal coalition in the adult is as in child ren but the clinical presentation may differ.