Congenital steep talus

Congenital steep talus (talus verticalis, congenital flat foot) is a relatively rare defect (1:100,000). Its etiology is unclear, often associated with other defects.

Clinical Aspect

• The Achilles tendon is shortened, the whole leg is in a valgus position, the talus is in a vertical position, the head of the talus protrudes on the inner and plantar surface of the foot (talus in marked plantiflexion) and forms the top of the cradle ( "cradle foot", in Czech "noha kolébková" ).
• as a result of the vertical position of the talus and the less pronounced equinosity of the calcaneus with simultaneous dorsal luxation of the os naviculare, a rigid congenitally flat foot results
• deep skin furrows in front of the ankle joint and below the outer ankle
• the main sign is rigidity, the front part of the leg is in dorsiflexion and correction to the plantigrade position is not possible
• dg. determined by clinical and X-ray examination

X-ray Image

• vertical position of the talus, which is oriented in the extension of the axis of the tibia, with which it forms an angle of 170–180° (hence the steep talus)
• s naviculare lies on the dorsal surface of the neck of the talus

Treatment

• treatment is problematic and almost always surgical (it always involves the lengthening of the Achilles tendon), we start with it immediately after the diagnosis is established
• it can be preceded by an effort to reduce the deformity with straightening plaster bandages
• during the operation, we try to reposition the bones in the correct position by loosening the soft tissues, which we fix with Kirschner wires

Links

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• Pes equinovarus congenitus