Diagnosis and Treatment of Adult Flatfoot. TARSAL COALITION.

[Refer to Pathway #1]

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Source: Clinical Practice Guideline Adult Flatfoot Panel. Diagnosis and treatment of adult flatfoot. J Foot Ankle Surg 2005 Mar-Apr;44(2):78-113. Diagnosis and Treatment of Adult Flatfoot TARSAL COALITION SIGNIFICANT HISTORY *+/- Symptoms. *Age: Typical Adolescent or Preadolescent. *+/- Weight Gain. *Altered Physical Activity. *+/- Trauma, Simple Sprain. Refer to Pathway #1 Diagnostic Imaging *Standard Radiographs. *Special Radiographic Views: - Harris-Beath. *CT. *MRI. *Bone Scan. SIGNIFICANT FINDINGS *Variable Rearfoot Pain. *Decreased or Absent Rearfoot ROM. *+/- Peroneal Spasm. *Rigid Flatfoot. DIAGNOSIS INITIAL TREATMENT OPTIONS *Footwear Modifications, Arch Supports, Orthoses. *Activity Modifications. *Appropriate Weight Reduction. *Immobilization. *Anti-inflammatory Medications. Recurrence of Symptoms Satisfactory Clinical Response Unsatisfactory Continue NonSurgical Options Consider Surgical Options *Resection of Coalition. *Arthrodesis. *Realignment Osteotomy. Observation &/or Orthoses PATHWAY 4 All copyrights are reserved by the American College of Foot and Ankle Surgeons.