Tarsal Coalition Excision

An overview of the surgical process, post-operative care, and rehabilitation guidelines for Tarsal Coalition Excision.

The Surgery

The surgery involves an incision over the coalition area.
The coalition is identified using x-ray in theatre and knowledge of anatomy (Nerves and tendons in the area are protected).
The coalition is removed and bone wax is placed over the bone ends.
Sometimes further foot reconstruction is required.

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Your child will wake up with bulky bandages and a boot.
Your child’s foot will be elevated overnight and will receive antibiotics through a drip.
Your child can walk in the boot the next day, but just for necessary things like going to the toilet. Otherwise, your child’s foot will become too swollen.

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Your child will need medications for pain relief which will be given to you from hospital (paracetamol and ibuprofen can be bought over the counter).
The first night after surgery is often when the worst pain is experienced, and the local anaesthetic wears off. Please give your child pain killers before they go to sleep.
Please leave all dressings intact until your appointment with Dr Graff 2-3 weeks.
Your child will get an appointment for your post op appointment in 2-3 weeks where the wounds will be reviewed and suture end trimmed (absorbable sutures are usually used).
After this your child will be able to shower normally and pat the dressings dry.

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*All patients are different. These timelines are only a guide, and some patients may progress faster or slower than others.

Your child can weight bear as tolerated in a boot, but only for essential things
Keep elevated at other times
Keep the boot on at all times like a plaster.
Pain relief: Please give your child regular Panadol with meals and before bed

Post op appointment with Dr Graff: dressings changed
Your child is allowed to weight bear as tolerated in the boot
Your child can remove the boot for showers and sleeping and range of motion exercises with physio
Your child can start static strengthening and balance exercises with physio

Your child can transition from the boot into normal sports shoes if the swelling allows
Your child can start increased strengthening with physio and wobble board

Your child can ease back into sport – start with walking, then running, then training
Once your child’s ankle feels as strong as the normal ankle, your child can return to sport (also be guided by your physio)

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2-3 weeks if the surgery is on their left foot (after the appointment with Dr Graff).
4-6 weeks if surgery is on their right foot (when they are no longer in the boot).

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3 months, but this is a transition; start with walks, then running, then training. You can be guided by your physio as to when your child’s strength and range of motion is back to normal to return to competitive sport.

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Please see ‘Tarsal Coalition’ Information sheet here.

If you want more information, or have any questions or problems, please contact Dr Graff on admin@christygraff.com or please call the rooms on 0493 461 133.