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

Related Articles

 * Pes planovalgus
 * Congenital limb defects
 * Arthrogryposis multiplex congenita
 * Non-positional leg defects
 * Positional defecets of the leg
 * Pes equinovarus congenitus