Background: Congenital vertical talus is an uncommon foot deformity and represent the most severe form of congenital flatfoot which is present at birth and results in a rigid flatfoot deformity characterised by a dislocated talonavicular joint in association with an equinus position of the calcaneus, this deformity if left untreated results in pain and disability, Traditional treatment of idiopathic congenital vertical talus usually consisted of 2 stages extensive soft tissue releases, these major reconstructive surgeries have lot of complications such as wound necrosis and or talar necrosis , undercorrection of the deformity, stiffness of the ankle and subtalar joint. the aim of this study was to evaluate the recent approach consists of limited one stage surgical intervention which resulted in promising results in the short term.
Patients and Methods: The study included a total number of 10 feet in 7 children, 4 of them (6 feet) suffered from neurological and musculoskeletal disorders as cerebral palsy (1 patient), myelomeningocele (1 patients, 2 feet), and arthrogryposis multiplex congenita. (2 patient, 3 feet), the rest of children were normal, the period of follow up ranged from 18 to 30 months, all patients were surgically treated by one stage surgical procedure of open reduction of the talonavicular joint and complete correction of the hindfoot equines, the age of operative interference ranged from five to seven months of life. Patients were evaluated clinically and radiologically at the time of presentation, immediate postoperative and at final follow up.
Results: initial correction was clinically and radiologically obtained in all 10 feet. At the final follow up the clinical results were good or excellent in 8 feet, 1 feet showed partial recurrence and 1 feet showed complete recurrence, none of them had pin fixation of the talonavicular joint, radiographic angle measurements returned to normal values in the 8 good or excellent feet.
Conclusion: Early operative treatment of congenital vertical talus results in very satisfactory clinical and cosmetic results which usually avoid extensive surgical procedures such as tendon lengthening and transfers
|
