A vertical talus or a congenital vertical talus is a rare disability of the foot that is normally found at birth. It’s an severe kind of flatfoot that may affect one or both feet. The talus bone is a smaller bone in the rearfoot that points frontward generally in a horizontal direction and sits amongst the tibia and fibula bones of the leg and the heel bone to make the ankle joint structure. With a foot with congenital vertical talus, the talus bone points towards the ground in a vertical posture. The outcomes with this is a inflexible and rigid foot with no arch which is often called a rocker bottom foot. The problem can happen by itself or can be part of a wider syndrome such as arthrogryposis or spina bifida. There’s also a less serious form of this problem referred to as oblique talus which is midway between the vertical and horizontal forms of the problem. This particular type is much more flexible and just shows up when weightbearing.
A congenital vertical talus is usually identified at birth, however it can sometimes be detected on ultrasound examination in the pregnancy. An evaluation of the feet will usually present the issue and is used to identify exactly how rigid it is. There is generally no pain to begin with, but if it’s left untreated the foot will remain deformed and with later walking it is going to generally become painful. An x-ray will obviously pick up the talus in its abnormal vertical placement. A number of doctors look at a congenital vertical talus to be a mild type of a clubfoot.
Normally, some surgical procedures are typically needed to manage the congenital vertical talus problem. Having said that, the orthopaedic surgeon might want to consider using a period of stretching or casting in an attempt to improve the flexibility and posture of the foot. While in only a few cases will this do away with the need for surgery completely it is more likely to lessen the amount and extent of surgical procedures that is needed and result in a much better final result from surgery. Bracing is required over a number of clinic visits and changed weekly to maintain moving the foot into a much more corrected posture. If there is too little of an improvement using this approach then surgical procedures will most likely be needed. The amount of the surgery may count on just how much the casting modified the foot and exactly how rigid the disability is. If the foot is rigidly deformed, then the surgical treatment will need to be more extensive and it is generally completed just prior to 1 year old. The whole purpose of the surgical procedure is to correct the positioning of the bones inside the foot. To do this usually needs a few tendons and ligaments to become extended to allow for the bones of the foot to be moved. Those bones are then held in place with pins and placed within a brace. These bone pins typically get taken out after four to six weeks. A special shoe or brace may need to be used for a period of time after that to continue to keep correction.
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Article by: Craig Payne September 18, 2022