Congenital Vertical Talus

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    10-Mar-2015
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Congenital Vertical TalusDr.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 doneTechnique of Kumar, Cowell, and Ramsey Three incisions Lateral, Medial, Posterior

Intra-op (Zhikov Maneuver)

post-op x-rays

Post-op ProtocolA/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 AssessmentDeformity 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