A vertical talus or a congenital vertical talus is a infrequently found disability of the foot that is normally found at birth. It is an extreme type of flatfoot that can affect one or the two feet. The talus bone is small bone inside the ankle which points frontward in a horizontal direction and sits amongst the tibia and fibula bones of lower leg and the heel bone to make the ankle joint complex. In a foot with congenital vertical talus, the talus points towards the ground in a vertical position. The effects with this is a stiff and rigid foot without any arch that is usually known as a rocker bottom foot. The condition can occur on it's own or could be part of a wider syndrome for example arthrogryposis or spina bifida. There's also a less serious form of this problem known as oblique talus that is halfway between the vertical and horizontal forms of the problem. This particular type is much more flexible and only shows up when weightbearing.
The congenital vertical talus is frequently clinically determined at birth, but it can occasionally be discovered on ultrasound during the pregnancy. An assessment of the foot will normally present the issue and it is used to decide precisely how inflexible it is. There is frequently no pain to begin with, however, if it is not dealt with the foot will remain disfigured and with later walking it will commonly become painful. An x-ray should clearly observe the talus in a increased vertical alignment. A number of specialists consider a congenital vertical talus as a mild form of a clubfoot.
Usually, some surgical treatment is usually needed to correct the congenital vertical talus problem. Having said that, the pediatric surgeon may like to try a amount of stretching or casting to try and increase the flexibility and position of the foot first. While in only a few cases will this eliminate the necessity of surgical treatment completely it is more likely to help reduce the total amount and extent of surgery that is required and lead to a far better outcome from surgery. Casting is needed over a number of visits and replaced weekly to keep moving the foot into a much more corrected position. If there is too little of an improvement using this process then surgery will most likely be required. The amount of the surgery could rely on just how much the casting improved the foot and how rigid the disability is. In the event the foot is rigidly deformed, then the surgery will have to be much more comprehensive and is typically carried out before 1 year old. The entire point of the surgical procedures are to improve the positioning of the bones inside the foot. To achieve this typically needs a few tendons and ligaments to become lengthened to permit the bones in the foot to be relocated. These bones will be kept in position with pins and placed within a splint. These bone pins typically get removed after 4 to 6 weeks. A particular shoe or splint may need to be worn for a period of time just after that to maintain the correction of the congenital vertical talus.
