A vertical talus or a congenital vertical talus is a rare deformity of the foot which is typically found at birth. It is an extreme type of flat foot that could impact one or both feet. The talus bone is a smaller bone inside the rearfoot that points ahead in a horizontal direction and sits amongst the tibia and fibula bones of lower leg and the calcaneus bone to create the ankle joint structure. With a foot with congenital vertical talus, the talus bone is directed towards the floor in a vertical direction. The effects with this can be a inflexible and rigid foot without any arch which is frequently known as a rocker bottom foot. The problem can occur on it’s own or could be part of a bigger syndrome including arthrogryposis or spina bifida. There is also a mild kind of this deformity called oblique talus that is midway between the vertical and horizontal types of the problem. This type is much more flexible and just shows up when weightbearing.
A congenital vertical talus will likely be diagnosed at birth, however it can occasionally be picked up with ultrasound exam in the pregnancy. An evaluation of the foot will usually show the problem and it is used to figure out just how inflexible it is. There’s usually no pain at first, but if it is not treated the foot will remain misshaped and with later walking it is going to generally turn out to be symptomatic. An x-ray should obviously pick up the talus in a increased vertical location. Some specialists consider a congenital vertical talus as a slight kind of a clubfoot.
Usually, some surgical treatment is usually required to correct the congenital vertical talus problem. However, the orthopaedic surgeon might want to consider using a amount of stretching out or casting to try and increase the flexibility and position of the foot. While in only a few cases will this eliminate the requirement for surgical treatment entirely it is more likely to decrease the total amount and magnitude of surgical procedures that is required and lead to a better outcome from surgery. Casting is required over a number of visits and changed weekly to keep moving the foot right into a more fixed position. If there is inadequate of an improvement using this approach then surgery will likely be required. The degree of the surgery may count on just how much the casting modified the foot and exactly how inflexible the deformity is. If the foot is rigidly deformed, then this surgery will need to be much more substantial and it is typically performed before one year of age. The whole reason for the surgical procedures are to correct the positioning of the bones within the foot. To do this usually needs several tendons and ligaments to become extended to allow the bones in the foot to be shifted. These bones are then kept in position with pins and put within a splint. These pins normally get removed after four to six weeks. A special shoe or splint may need to be worn for a period of time following that to retain the correction.