Background: Although its mechanism is not clear, tarsal coalition is shown to be associated with cavus foot in a few cases. Except one, all reported cases are children or adolescents. The first line of treatment is conservative (most patients benefit). In refractory cases, soft tissue procedures or very rarely osteotomies are used for treatment.There is no algorithm for treatment of
cavus foot with tarsal coalition in an adult.
Case Report: We report a case of talocalcaneal coalition in a 29 years old male which is refractory to conservative treatment.
Conclusions: The management of cavus foot with tarsal coalition unresponsive to conservative treatment in an adult, remains as a challenging problem for the orthopedic surgeon. Futher study is needed to understand the mechanism of this entity and to treat it effectively.

Keywords: Foot Deformities