Causes and risk factors
In vertical talus, there occurs abnormal dorsal dislocation of the navicular over the talus. This dislocation is rigid and nonreducible. The exact cause for this is not known. However, studies have shown that it is more commonly associated with certain neuromuscular disorders. Abnormal variation of the muscle fibers can also lead to vertical talus. In most of the cases, the cause is idiopathic.
Clinical presentation:
The complaints can be unilateral or bilateral. A child suffering from vertical talus has no arch. Flat foot is seen. The foot is arched outside, giving a rocker bottom appearance to the foot. Because of this deformity, the child suffers from difficulty in walking. Cosmetically, the foot appears deformed. Walking with deformed foot makes the foot more vulnerable to callus and variety of skin problems of the foot.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the parents and the physical examination carried out by the orthopedic doctor. Clinically observing the child along with certain physical test helps in diagnosis. Ultrasound performed during pregnancy can also help in diagnosing the condition. Investigations which are done are x-ray of the bone. Routine x-rays, usually, or specialized digital x-rays along with CT scan and MRI are advised.
Treatment:
Surgical intervention is the only choice of treatment. Surgery aims at repositioning the dislocated bones. After surgery, a temporary cast can be applied. Medications to allay the pain can be advised. Use of brace or special shoes is recommended. Physical exercises for stretching and improving the deformity are advised.
