Foot orthoses for tarsal coalition

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Hi All
Just wondering if anyone could provide info/opinions on best orthoses management/prescription for tarsal coalitions in kids? Have read a bit of conflicting material lately.
Thanks

 

Re: orthoses for tarsal coalition

Tarsal coalition hurts to move --> use foot orthotics to stop movement in the direction that it hurts to move.

Surgery is a better option.

 

Re: orthoses for tarsal coalition

Craig:

Can't agree with you that surgery is a better option for tarsal coalitions. Appropriately made custom foot orthoses have made 75% of my patients with tarsal coalition asymptomatic. Custom foot orthosis therapy is the first line option and, if they fail, then surgery is certainly an available option. I have seen some tarsal coalition surgical patients have more pain after surgery than before their surgery...surgery wasn't a better option for these individuals.

 

Maybe I am overgeneralising, but I just seen too many in the last few years with the 'bag full' of failed orthotics from several different type of clinicians - you know the the patient - they really been mucked around too much.