Talonavicular coalition is a rare entity and is often discovered as a secondary radiographic finding. Today, orthoses are as varied as the patients for whom they are prescribed; however, in cases of symptomatic talonavicular fusion, the use of a shallow U-shaped dispersion within the high medial flange of an orthosis can prove beneficial to the pediatric patient. This article encourages podiatric physicians to return to utilizing basic diagnostic tools (gait analysis, biomechanical examination, and radiographs) to detect and treat talonavicular coalition, a significant but rare anomaly of the foot.