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Ahn, Kang, Lim, and Kim: Results of Surgical Treatment for Congenital Vertical Talus
Original Article

Journal of the Korean Orthopaedic Association 2015; 50(5): 394-400.

Published online: 23 October 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.5.394

Results of Surgical Treatment for Congenital Vertical Talus

Tae Young Ahn, M.D., Jeong Han Kang, M.D., Kuk Pil Lim, M.D., Hui Taek Kim, M.D.

Department of Orthopedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

Correspondence to: Hui Taek Kim, M.D. Department of Orthopedic Surgery, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea. TEL: +82-51-240-7248, FAX: +82-51-274-8395, kimht@pusan.ac.kr

Received 25 December 2014       Revised 16 February 2015       Accepted 15 May 2015

Copyright © 2015 by The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We performed clinical and radiological evaluation of surgical outcomes of congenital vertical talus.

Materials and Methods

Fifteen surgically treated feet in 9 patients (6 bilateral and 3 unilateral) which were followed-up for at least 2 years were included. Mean patient age at the time of surgery was 10.9 months. The surgical technique was a one-stage correction using the Kumar technique with a Cincinnati skin incision. In 7 feet we also transferred half of the tibialis anterior to the talar neck (the Grice technique). Radiologic parameters (talo-calcaneal angle, talo-first metatarsal angle, tibio-talar angle, tibio-calcaneal angle) were analyzed pre- and postoperatively and at the last follow-up, and clinical outcomes by the Laaveg-Ponseti score.

Results

Talus orientation was improved in all patients. All radiologic parameters showed statistically significant improvement by the last follow-up. The mean Laaveg-Ponseti score at the last follow-up was 16 for patient satisfaction, 16 for function, and 24 for pain. There was no recurrence, however one case of talar neck fracture occurred during the tibialis anterior transfer.

Conclusion

One-stage surgical correction for congenital vertical talus at an early age provides satisfactory functional and cosmetic results.

Keywords: congenital vertical talus, single-stage release

Figures and Tables

Figure 1

Radiologic parameters measured in anteroposterior (A) and lateral (B, C) views: talo-calcaneal angle (T-C angle: the angle between the mid-talar and mid-calcaneal axes); talo-first metatarsal angle (T-M angle: the angle between the mid-talar and mid-first metatarsal axes); tibio-talar angle (Ti-T angle: the angle between the mid-tibia and mid-talar axes); tibio-calcaneal angle (Ti-C angle: the angle between the mid-tibia and mid-calcaneal axes).

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Figure 2

Anteroposterior (A) and lateral (B) radiographs of a 10-month-old patient (case 3) with left congenital vertical talus. (C) Photograph showing a rocker-bottom deformity. (D, E) Radiographs taken 7 years after surgery (when the patient was 8 years old) showing correction of the vertically oriented talus. (F) Photograph taken at the last follow-up shows satisfactory correction of the deformity.

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Table 1

Demographics and Clinical Data of 15 Cases of Congenital Vertical Talus in 9 Patients

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*These technique includes tibialis anterior transfer to the talar neck (Grice technique)

Table 2

Changes of Radiographic Angle and Clinical Outcomes

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T-C, talo-calcaneal; T-M, talo-1st metatarsal; Ti-C, tibio-calcaneal; Ti-T, tibio-talar; Preop, preoperative; Postop, postoperative; F/U, follow-up; Rt, right; Lt, left. *Wilcoxon signed rank test between preoperative and last follow-up angle (p<0.05).

Table 3

Laaveg-Ponseti Score

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Notes

This work was supported with clinical research in the 2015 Pusan National University Hospital.

CONFLICTS OF INTEREST The authors have nothing to disclose.

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