EARLY SURGICAL-TREATMENT FOR CONGENITAL VERTICAL TALUS

Congenital vertical talus is characterised by a dislocated talonavicul ar joint in association with an equinus position of the calcaneus. We report the results in 13 operated feet in 10 children, 3 of whom (5 fe et) presented with a primary neurological disorder and 2 of whom (3 fe et) suffered from arthrogryposis multiplex congenita. The other childr en were normal. All patients were surgically treated by a one-stage pr ocedure which included reduction of the talonavicular joint and correc tion of the hindfoot equinus, trying to avoid tendon lengthenings and transfers. The age at operation was between the 3rd and the 6th month of life, with one child being operated on later due to other reasons. The patients were reviewed after an average time of 3.5 +/- 2.2 years. The clinical results were good or excellent in ten feet. Two feet sho wed partial or complete recurrence and one foot was slightly overcorre cted. Radiographic angle measurements (talo-metatarsal I angle and tal ocalcaneal angle on the anteroposterior radiograph; talocalcaneal, tib iotalar and tibiocalcaneal angles on the lateral radiograph) returned to normal values in the ten good or excellent feet. Early operative tr eatment for congenital pes vertical talus leads to very satisfactory f unctional and cosmetic results, usually avoiding extensive procedures including tendon lengthenings and tendon transfers.