Single-Stage Surgical Correction of Congenital Vertical Talus

Abstract

Forty-one patients (55 feet) with congenital vertical talus (CVT) were reviewed. Thirty of the feet were associated with neural tube defects, 10 with neuromuscular disorders, five with congenital malformation syndromes, and none with chromosomal aberrations. Ten of the feet were idiopathic. All were treated with a single-stage surgical correction as described, by using the Cincinnati incision, and performed by the same surgeon. Thirty-two patients (42 feet) were available for clinical and radiographic follow-up averaging 7 years (range, 2-12) from the time of surgery. There were no wound complications or avascular necrosis of the talus. In 10 feet, subsequent reoperation was necessary. At final follow-up, results were based on the clinical and radiographic outcomes and included 31 good and 11 fair. All patients and families were satisfied with the results and appearance of the feet. There were no bony prominences or skin problems. The presence of mild pain was noted in only three feet. Radiographically, there was a significant improvement in the anteroposterior (AP) and lateral talocalcaneal and talo-first metatarsal angles, and at follow-up, the group averages for each of these angles were within the normal range. In treating CVT, good clinical and radiographic results can be obtained with a low incidence of complications using this single-stage surgical correction of the hindfoot and midfoot deformities.