Congenital vertical talus
Rare. Dorsal dislocation of navicular on head of talus (may be a form of clubfoot).
Cause unknown – but intrauterine position, genetic and neuromuscular conditions have been implicated. May be isolated deformity of part of another syndrome (eg arthrogryposis multiplex congenita; neurofibromatosis; nail-patella syndrome).
Rocker bottom appearance to foot; talus is prominent talus head in plantar medial side of foot; dorsal creasing in the MTJ region; rigid STJ; forefoot is abducted and dorsiflexed.
On x-ray, the dorsal dislocation of the navicular off the head of the talus onto the talar neck is seen
Posterior tibial tendon is more dorsally located acts as a dorsiflexor
1. Dislocation of talonavicular joint, subluxation of subtalar joint, normal calcaneocuboid joint (more flexible)
2. Dislocation of talonavicular joint, subluxation of subtalar joint and calcaneocuboid joint, ankle joint equinus (more rigid)
Initially treatment at birth is manipulation and casting – later treatment is surgical. Prognosis is often not good without