Vertical Talus: Causes, Symptoms, Treatment, Recovery, Prognosis

When studying about foot deformities one comes across a congenital foot deformity called as Congenital Vertical Talus. This condition is one of the causes of flatfeet in children. This condition can affect one or both feet. Congenital Vertical Talus is not a painful condition but if it is not treated appropriately and on time it may have serious consequences and may even be a reason for disability in the affected child. To understand Congenital Vertical Talus, it is important to understand the anatomy of the foot. The talus is a very small bone, which is situated between the calcaneus and the tibia and fibula. The tibia and the fibula is situated around the side of the talus and forms the ankle joint. The talus is an important bone as it connects the foot to the leg and facilitates weight transfer across the ankle joint. Now coming to Congenital Vertical Talus, in this condition the talus bone is formed at an incorrect position resulting in other bones to shift on top of the bone. This causes the front part of the foot to point vertically. The bottom of the foot becomes stiff and curves out causing a condition called rocker bottom foot. This condition is identified immediately after birth and at times even before if an ultrasound of the fetus is conducted. This condition is quite rare and is often misinterpreted as some other foot deformity before an actual diagnosis is made.

What causes Congenital Vertical Talus is still a matter of research but some studies have suggested that most of the cases of Congenital Vertical Talus are connected to a neuromuscular disease condition like spina bifida, neurofibromatosis and the like. Hence if a Congenital Vertical Talus is suspected in a child the physician may perform additional test to rule out an underlying neuromuscular disorder.

Since Congenital Vertical Talus is a visible deformity hence there are no specific studies required to diagnose it, although since it resembles so many other foot deformities and it itself is a rare disorder it can easily be misdiagnosed as some other foot deformity, hence it is important to rule out other foot deformities to conclusively diagnose Congenital Vertical Talus.

The main aim for treatment of Vertical Talus is to improve the function of the foot, make the foot more stable and to eliminate any pain that the child may be having. Here it is important to note that Vertical Talus needs to be treated as early as possible hence its early diagnosis is vital for early treatment. If this deformity is not corrected on time then it may lead to potentially serious consequences like abnormal ambulation and extreme pain with walking. It may render the child disabled. Vertical Talus can be corrected both surgically as well as non-surgically. Below mentioned are some surgical as well as nonsurgical methods of correcting Vertical Talus.

Nonsurgical Approaches To Treat Vertical Talus: The treating physician uses this method of treatment to begin with as a trial to see if the condition improves. The nonsurgical methods of treating Vertical Talus are extensive stretching exercises to begin with which will be formulated by the therapist to increase the flexibility and strength of the foot. These exercises, along with serial casting, makes the foot more flexible and in some cases have even corrected the deformity. Diligent continued physical therapy exercises as given by the therapist also go a long way in helping to correct Vertical Talus. One important point to note here is that when the child is in a cast or a brace the parents must watch for any discoloration of the skin and if the affected foot feels warm to touch as this may point to a problem with the circulation.

Surgical Approaches To Treat Vertical Talus: In cases where conservative approaches fail to yield any positive results then the physician recommends a surgical correction of the deformity, which is normally done between 8 and 12 months of age. The procedure is done in such a way that it not only corrects the deformity but it covers all the aspects involved to include any problems with the bones, tendons, or ligaments. While doing the surgery, the surgeon will place the bones back to their normal position and pin them so that they do not move out of their position. Tendon and ligament lengthening may also be performed in case the deformity has led to shortening of the tendons and ligaments.

Post procedure, the child’s foot is casted to keep the position of foot maintained in the normal anatomical fashion. The child will be observed in a hospital setting overnight to look for presence of any pain or swelling of the foot postsurgery. The child will remain in the cast for a period of about six weeks after which the cast is removed and the child is placed in a brace of a special shoe designed for such foot deformities to avoid recurrence.

If the child is not treated appropriately then as stated above it may render the child disabled and the child may suffer from unbearable pain and difficulty with walking but with adequate treatment both conservative and surgical the prognosis for correction of the deformity is quite good and the parents can expect a stable functioning foot of the child without any potential recurrence. Once treatment course is over and the deformity is successfully corrected then the child more often than not is able to run and play and wear normal shoes without any problems. The physician post-treatment may followup with the child for a few years to check whether the child is developing normally and also to look at the condition of the foot after treatment of Vertical Talus.

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