Vertical Talus is a foot deformity that occurs at the time of birth. It is a rare condition that affects the talus, a small bone that is placed between the lower leg bones (fibula and tibia) and the calcaneus (heel bone) to form the ankle joint. This bone acts an important node between the foot and the leg that enables transfer of body weight on to the foot while walking and other physical activities. Congenital Vertical Talus disrupts the formation of the talus bone which in turn displaces the other two bones of the lower leg that then shift on top of the talus. Either one or both the feet may get affected. This condition is also a major cause of Flatfoot formation in newborns. It may lead to serious disability in later life, if left untreated.
Causes
- Neuromuscular disorders in the baby
- Spina bifida
- Neurofibromatosis
- Arthrogryposis
- Genetic mutation of a set of genes may be responsible
Symptoms
- The forefoot tends to point upwards
- The forefoot may turn up to touch the shin bone
- Absence of foot arch ( Flatfoot )
- The base or bottom of the foot may be turned outwards which is why this condition is also referred to as the ‘rocker bottom’
- Pain is generally not felt
- Foot may be stiff
- Abnormal gait
- Callouses may develop if the child starts walking with this condition
Diagnosis
- Congenital Vertical Talus may be diagnosed before birth if an ultrasound is performed
- Detailed clinical examination of the foot to check for the symptoms of deformity and degree of bone deformity
- X-ray imaging to assess the bone structure
- Some lab tests may be recommended
- MRI or CT scan to asses the condition of the surrounding soft tissue structures
Treatment
- Casting the affected foot in a brace may help correct the deformity in early stages of life
- Regular stretching and gentle exercises prescribed by a physical therapist may be helpful to restore the correct anatomical shape of the foot and improving its flexibility
- Surgery may be recommended after the child attains 10-12 months of age, if the conservative treatment fails to give results. It may be done to realign the bones and fasten them using pins and screws
- The ligaments and tendons may be lengthened surgically to facilitate the movement of the ankle joint
- The foot may be immobilized in a cast for a couple of weeks post surgery to aid recovery
- The child is advised to get regular checks done to monitor his/her growth post treatment
- Special walking boot may be used to improve the condition and prevent reoccurrence