Post on 10-Mar-2015
Congenital Vertical Talus
Dr.E.Kaizar Ennis Dr.Cherian Kovoor EMC,Cochin.
History
2 yrs /male
Brought by parents with deformity Rt foot
Examination
Rocker-bottom deformity Rt
Clinical picture
Radiology Rt
What we have done…
Technique of Kumar, Cowell, and Ramsey Three incisions Lateral, Medial, Posterior
Intra-op (Zhikov Maneuver)
post-op x-rays
Post-op Protocol
A/K slab applied A/K cast given after SR which was
continued for 3 months K-wires removed at 3 months Wt. bearing started at 3 months
3 months post-op
One yr post-op
Cont…
One yr post-op
Clinical Photos(2 & half yrs)
Cont…
Cont…
Two & half yrs post-op -Dorsiflexion
Plantarflexion
Post-op Assessment
Deformity Corrected Mild forefoot Abduction Dorsiflexion 30 deg Plantarflexion 0 deg
Treatment Options
Reverse Ponseti tech. The exact surgery indicated is determined by the
age of the child and the severity of the deformity.
Treatment Options cont..
Young child with a mild or moderate deformity, the technique of Kumar, Cowell, and Ramsey is recommended .
Older child with a more severe or a recurrent deformity, Coleman et al. recommend open reduction and a Grice extraarticular subtalar fusion .
Child 12 years old or older with functional symptoms, a triple arthrodesis is preferred .
Differential diagnosis
Calcaneovalgus deformity
Take home message
ALL CASES OF FLAT FOOT R/O CVT
THANK YOU