The Ponseti method has proven to be successful in the treatment of idiopathic congenital talipes equinovarus (clubfoot). In particular, if plaster cast treatment as recommended by Ponseti does not show the desired correction of the foot, tarsal coalitions as a rare cause for a secondary clubfoot deformity have to be ruled out. In these cases a surgical release of the coalition in addition to the tenotomy has to be performed to achieve a satisfactory correction.

We report the case of a 15-year-old male with bilateral talocalcaneal coalition. Following resection of the symptomatic coalition, the patient developed a painful ankle. MR imaging revealed a stress fracture of the talar body. In this report we discuss presentation and treatment of a symptomatic talocalcaneal coalition complicated by a later stress fracture as well as a review of the literature.