Vertical Talus

   Vertical Talus is a condition that produces a rocker-bottom deformity of the foot.
Correction of neglected deformities in an older child is difficult. In severe deformities full correction is not possible.
Surgical correction difficulty depends on the severity of the deformity, the associated diagnoses and the age of the patient.
The term Vertical Talus should be reserved for feet with fixed equinus of the calcaneus and dorsal dislocation of the navicular on the talus.
Vertical Talus may be present along more commonly in association with other neuromuscular condition. It is most often present in association with myelomeningocele and arthrogryposis.
The calcaneus is fixed in equinus and the Achilles tendon is contracted. The peroneal and anterior tibialis tendon are taught, and the foot is everted into a valgus, externally rotated position.
The navicular is palpable as it lies on the talar neck where it abuts the anterior tibial surface at the front of the ankle joint. There may be some flexibility of the foot, but passive correction of deformity is not possible.
Serial cast treatment has been recommended and tried by many.
Manipulation and casting may be effective in milder cases.