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Congenital vertical talus , sometimes called "rocker-bottom foot," is a rare birth defect of the foot in which the talus bone has formed in the wrong position and other foot bones have shifted on top of it. As a result, the front of the foot points up and the bottom of the foot is stiff and has no arch (flatfoot), usually curving outward like the bottom of a rocker. One or both feet may be affected. The underlying cause of vertical talus is usually not known. It can occur by itself (isolated) or may be associated with a genetic syndrome or neuromuscular disorder. Rare familial cases have been reported, some due to a mutation in a gene called HOXD10. While vertical talus is not painful in very early childhood, if left untreated it typically leads to pain and disability later in life. Treatment usually involves surgery before one year of age to correct the problems with the bones, and the ligaments and tendons that support the bones.
Source: GARD Last updated on 05-01-20
Congenital vertical talus should be treated early to avoid pain and disability when the child learns to walk. The most common treatment is surgery, but some doctors may first recommend trying nonsurgical treatment. This may include a series of stretching and serial casting to increase the flexibility of the foot. This may decrease the amount of surgery that is needed, or, in some cases, prevent the need for surgery.
In most cases, surgery is recommended at around 9 to 12 months of age. The goal of surgery is to correct all aspects of the deformity, which includes the position of the bones as well as the ligaments and tendons that support these bones. When the bones are put in the correct position, pins may be inserted for a few weeks to keep them in place. Any tendons or ligaments that may have shortened as a result of the deformity may be lengthened. In most cases, recovery with a cast takes about 4 to 6 weeks. A brace or special shoe may be needed for a period of time to prevent the deformity from returning.
If congenital vertical talus occurs in association with other birth defects or an underlying genetic syndrome or neuromuscular disorder, treatment recommendations may differ depending on the associated abnormality.
Last updated on 05-01-20
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