What is the natural history ?
The majority of painful coalitions can be managed by appropriate conservative treatment but some degree of foot stiffness will persist. Those coalitions that continue to produce pain despite best treatment usually require removal.
How do you treat it ?
It is important that a firm diagnosis is made both clinically and with cross sectional imaging by with CT or MRI. If immobilisation, injection and physiotherapy fail to relieve symptoms the coalition is surgically removed and a graft of fat placed in the defect to stop regrowth of bone. Some patients may require correction of secondary foot deformities as part of the treatment.