Tarsal Coalition

Foot Facts

  • Each foot has 26 bones
  • There are more than 100 ligaments in each foot
  • Diabetes is the #1 cause for lower extremety amputation
  • A toenail takes 4-9 months to completely grow out
  • Pain in the feet is NOT normal

Surgery: YES OR NO????

  • Deciding whether or not to have surgery is a big decision. 
  • Our foot and ankle surgeons are skilled in both surgical and conservative options. 
  • We will present the options most suitable for you and help you with your decision.

How much pain should I be in before I make an appointment?

  • Foot pain is not normal.
  • Foot pain is a signal that something is not right.
  • Any degree of foot pain warrants an evaluation to determine the source of the pain and possible treatment options.
  • Most foot pain left untreated will get worse and become more difficult to cure.
  • If you have foot or ankle  pain, make an appointment, do not wait.

Will soaking cure my ingrown toenail?

  • Soaking an ingrown toenail will often make it feel better, but it will not cure it. 
  • The symptoms of an ingrown toenail include pain, redness, and swelling.
  • An ingrown toenail is easily cured with a simple in office surgical procedure. 
  • The toe is anesthetized so that pain is not felt during the procedure.
  • The ingrown nail, or portion of the nail, is removed.
  • Most people feel no pain afterwards and return to normal activities the next day. 

What are orthotics?

  • Custom made foot arch supports designed to hold the foot in its optimum position
  • Can alleviate the discomfort caused by a number of foot conditions such as heel pain, bunions, and flat feet. 

Happy Feet...Happy Bride

happyComfortable footwear can help make the perfect day even better. Many times foot or ankle discomfort can be alleviated with appropriate shoes. It is not unusual for people to buy shoes that are too small for their feet. If your foot problem has an easy solution, our podiatrists will gladly provide you with that information. Sometimes the right shoe is not enough and custom-made orthotics is necessary to help the feet maintain the best position. Our podiatrists can utilize a three dimensional digital scan to have custom made inserts (orthotics) fabricated for your shoes, made from the scan of your feet to correct your specific foot abnormality and fit your feet only. If your foot or ankle problem can be resolved with conservative treatment, our podiatrists will advise you of the best treatment for you. There are times when the best solution for a foot or ankle problem is surgery. If you require foot or ankle surgery, our podiatrists can provide you with the latest state of the art surgical techniques. They will take the time to explain to you what to expect before, during and after surgery and will try to answer all your questions. Whatever your foot or ankle problem may be, our podiatrists will explain the various treatment options available to you. Everyone is happier when their feet are happy!

Thoughts on Celebrating 30+ Years

anniversarySome thoughts from Dr. Jacoby:
On April 30, 1984 I took over this podiatry practice. Elgin became my professional home as well as my personal home. I am forever grateful to Dr. Roger Hess who started this practice 50 years prior. Dr. Hess was a gentleman whom I admired and emulated both professionally and personally. I am forever honored to continue caring for the patients who initially trusted Dr. Hess.

My first office was at 860 Summit on the East Side of Elgin. I remember painting the office myself. I moved twice into larger space at 860 Summit. Eventually we outgrew the space there and moved to larger space at the Sherman Hospital Medical Building and then finally here to 750 Fletcher. I am grateful to the multitude of patients we have had the privilege of treating and that have kept us growing. I am also grateful to the multitude of other physicians in the area whom I am so privileged to work with.

Not only has this practice grown in physical space, but we have grown technologically as we offer many state of the art alternatives.  My staff has been and continues to be essential.  To all my staff, both past and present, I say a most sincere Thank You.

I look back on the years with much pride and sentimentality. I look forward to the future with the same enthusiasm and joy I felt on April 30, 1984. I love what I do and every day I realize how blessed I am to be in this wonderful profession!

What is a Tarsal Coalition?
A tarsal coalition is an abnormal connection that develops between two bones in the back of the foot (the tarsal bones). This abnormal connection, which can be composed of bone, cartilage, or fibrous tissue, may lead to limited motion and pain in one or both feet.

 

TarsalcoalitionThe tarsal bones include the calcaneus (heel bone), talus, navicular, cuboid, and cuneiform bones. These bones work together to provide the motion necessary for normal foot function.

Causes
Most often, tarsal coalition occurs during fetal development, resulting in the individual bones not forming properly. Less common causes of tarsal coalition include infection, arthritis, or a previous injury to the area.

Symptoms
While many people who have a tarsal coalition are born with this condition, the symptoms generally do not appear until the bones begin to mature, usually around ages 9 to16. Sometimes there are no symptoms during childhood. However, pain and symptoms may develop later in life.

The symptoms of tarsal coalition may include one or more of the following:

  • Pain (mild to severe) when walking or standing
  • Tired or fatigued legs
  • Muscle spasms in the leg, causing the foot to turn outward when walking
  • Flatfoot (in one or both feet)
  • Walking with a limp
  • Stiffness of the foot and ankle

Diagnosis
A tarsal coalition is difficult to identify until a child’s bones begin to mature. It is sometimes not discovered until adulthood. Diagnosis includes obtaining information about the duration and development of the symptoms as well as a thorough examination of the foot and ankle. The findings of this examination will differ according to the severity and location of the coalition.

In addition to examining the foot, the surgeon will order x-rays. Advanced imaging studies may also be required to fully evaluate the condition.

Non-surgical Treatment
The goal of non-surgical treatment of tarsal coalition is to relieve the symptoms and reduce the motion at the affected joint. One or more of the following options may be used, depending on the severity of the condition and the response to treatment:

  • Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
  • Physical therapy. Physical therapy may include massage, range-of-motion exercises, and ultrasound therapy.
  • Steroid injections. An injection of cortisone into the affected joint reduces the inflammation and pain. Sometimes more than one injection is necessary.
  • Orthotic devices. Custom orthotic devices can be beneficial in distributing weight away from the joint, limiting motion at the joint and relieving pain.
  • Immobilization. Sometimes the foot is immobilized to give the affected area a rest. The foot is placed in a cast or cast boot, and crutches are used to avoid placing weight on the foot.
  • Injection of an anesthetic agent. Injection of an anesthetic into the leg may be used to relax spasms and is often performed prior to immobilization.

When is Surgery Needed?
If the patient's symptoms are not adequately relieved with nonsurgical treatment, surgery is an option. The foot and ankle surgeon will determine the best surgical approach based the patient's age, condition, arthritic changes, and activity level.