Background: A tarsal coalition is a bridging of two or more of the bones in the hindfoot. Multiple coalitions are described in the literature. However, the presence of a tibio-talar coalition has not previously been reported.Results : Here, we describe the first reported case of tibio-talar and fibulo-talar coalition in the literature in a 31year-old male. The patient had a 5-year history of bilateral hindfoot and ankle pain, with an established right sided talo-calaneal coalition. Investigations and subsequent open chilectomy and debridement surgery confirmed a tibio-talar and fibulo-talar coalition. The patient was discharged at one-year following surgery as he was pain free and returned to work. Conclusions:We report the first case of failure of mesenchymal segmentation leading to tibio-talar fibrous coalition and fibulo-talar coalition. In this case surgical debridement provided resolution of symptoms. Level of Clinical Evidence: 4

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