Congenital Vertical Talus (convex pes valgus)

Question 1

What are the physical exam findings of congenital vertical talus?

Answer 1

rockerbottom (convex pes valgus) deformity:

1) fixed hindfoot equinovalgus
2) rigid midfoot dorsiflexion
3) forefoot abducted

Question 2

What are the radiographic findings in congenital vertical talus?

Answer 2

Lateral:

1) vertically oriented talus
2) line in long axis of talus passes below the first metatarsal-cuneiform axis (does not reduce with foot dorsiflexion)

AP:
1) talocalcaneal angle >40 deg

Question 3

What is the treatment for congenital vertical talus?

Answer 3

1) serial casting to stretch dorsal soft tissues prior to surgery
2) surgical release of soft tissue and posterolateral taught tendons with reduction and pinning

Question 4

Congenital vertical talus is commonly a/w?

Answer 4

Neuromuscular disease; 50%
myelodysplasia (common)
arthrogryposis
diastematomyelia
chromosomal abnormalities