J Korean Orthop Assoc.  2015 Oct;50(5):394-400. 10.4055/jkoa.2015.50.5.394.

Results of Surgical Treatment for Congenital Vertical Talus

• Ahn TY
• Kang JH
• Lim KP
• Kim HT

• KMID: 2185102
• DOI: http://doi.org/10.4055/jkoa.2015.50.5.394

Abstract

PURPOSE
We performed clinical and radiological evaluation of surgical outcomes of congenital vertical talus.
MATERIALS AND METHODS
Fifteen surgically treated feet in 9 patients (6 bilateral and 3 unilateral) which were followed-up for at least 2 years were included. Mean patient age at the time of surgery was 10.9 months. The surgical technique was a one-stage correction using the Kumar technique with a Cincinnati skin incision. In 7 feet we also transferred half of the tibialis anterior to the talar neck (the Grice technique). Radiologic parameters (talo-calcaneal angle, talo-first metatarsal angle, tibio-talar angle, tibio-calcaneal angle) were analyzed pre- and postoperatively and at the last follow-up, and clinical outcomes by the Laaveg-Ponseti score.
RESULTS
Talus orientation was improved in all patients. All radiologic parameters showed statistically significant improvement by the last follow-up. The mean Laaveg-Ponseti score at the last follow-up was 16 for patient satisfaction, 16 for function, and 24 for pain. There was no recurrence, however one case of talar neck fracture occurred during the tibialis anterior transfer.
CONCLUSION
One-stage surgical correction for congenital vertical talus at an early age provides satisfactory functional and cosmetic results.

Keyword

congenital vertical talus; single-stage release

MeSH Terms

Follow-Up Studies
Foot
Humans
Metatarsal Bones
Neck
Patient Satisfaction
Recurrence
Skin
Talus*

Figure

• 

  Figure 1 Radiologic parameters measured in anteroposterior (A) and lateral (B, C) views: talo-calcaneal angle (T-C angle: the angle between the mid-talar and mid-calcaneal axes); talo-first metatarsal angle (T-M angle: the angle between the mid-talar and mid-first metatarsal axes); tibio-talar angle (Ti-T angle: the angle between the mid-tibia and mid-talar axes); tibio-calcaneal angle (Ti-C angle: the angle between the mid-tibia and mid-calcaneal axes).

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  Figure 2 Anteroposterior (A) and lateral (B) radiographs of a 10-month-old patient (case 3) with left congenital vertical talus. (C) Photograph showing a rocker-bottom deformity. (D, E) Radiographs taken 7 years after surgery (when the patient was 8 years old) showing correction of the vertically oriented talus. (F) Photograph taken at the last follow-up shows satisfactory correction of the deformity.

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