A vertical talus or a congenital vertical talus is a uncommon deformity of the foot which is in most cases present at birth. It's an extreme type of flatfoot that can affect one or the two feet. The talus bone is small bone within the ankle which points frontward generally in a horizontal direction and sits between the tibia and fibula bones of lower leg and the heel bone to make the ankle joint complex. With a foot with congenital vertical talus, the talus is directed towards the floor in a vertical posture. The implications with this is usually a inflexible and rigid foot with no arch which is often termed as a rocker bottom foot. The issue can happen by itself or might be part of a bigger syndrome such as arthrogryposis or spina bifida. There's also a mild form of this deformity referred to as oblique talus which is halfway between the vertical and horizontal types of the deformity. This sort is far more flexible and just appears when standing.
A congenital vertical talus is normally determined at birth, however it can sometimes be detected with ultrasound examination in the pregnancy. An assessment of the foot will generally identify the issue and it is used to figure out exactly how rigid it is. There is usually no pain initially, however, if it is not treated the foot will stay disfigured and with later weightbearing it will eventually commonly turn out to be symptomatic. An x-ray can clearly detect the talus in its increased vertical position. A number of specialists look at a congenital vertical talus as a minor type of a clubfoot.
Generally, some surgery is typically necessary to fix the congenital vertical talus problem. Nevertheless, the pediatric surgeon might choose to use a amount of stretching or casting to try and increase the mobility and posture of the foot. While in just a few cases will this eliminate the requirement for surgical treatment altogether it is more likely to help reduce the amount and magnitude of surgical procedures that is needed and result in a far better end result from surgery. Casting is necessary over a number of clinic visits and changed weekly to help keep moving the foot into a much more corrected placement. If there is insufficient of an improvement using this process then surgical procedures will most likely be needed. The extent of the surgical treatment may rely on precisely how much the casting improved the foot and how inflexible the deformity is. If the foot is rigidly misshaped, then the surgery will need to be more comprehensive and is generally completed before 1 year old. The whole reason for the surgery is to improve the positioning of the bones inside the foot. To achieve this typically requires some tendons and ligaments to be lengthened to allow for the bones in the foot to be moved. Those bones are then held in position with screws and put in a splint. These bone pins generally get removed after 4 to 6 weeks. A particular shoe or brace may need to be worn for a period of time after that to maintain the correction.