PAGE 38 |
the foot ( see figure 4 ). This |
performed without compromising |
idiopathic congenital condition |
painful gait that is unlikely to cor- |
enough time and care to convince the |
may be in the form of fibrous , carti- |
post-anaesthetic outcomes . Unfortu- |
resulting in an abnormal posture of |
rect without surgical intervention . A |
family that no treatment is necessary . 4 |
|
laginous or bony connections . The |
nately , owing to the fixed mechani- |
the talus in the hindfoot . While con- |
multidisciplinary team dedicated to |
The best form of management for |
|
most common site is the calcaneo- |
cal block in these cases , there are no |
genital vertical talus ( CVT ) has been |
both the surgical and post-surgical |
a flexible paediatric flat foot is reas- |
|
navicular region in younger children |
corrective exercises that will improve |
shown to have a familial inheritance , |
aspects is required to correct these |
surance that this condition , in most |
|
and the middle facet of the talocalcaneal joint in adolescents . The failure of segmentation results in a lack of |
the flat foot deformity . Treatment in the acute phase is purely supportive . Pain relief , comfortable accommoda- |
the absolute incidence , inheritance and aetiology are unknown . 7 , 8 The vertical position of the talus results |
deformities . Diagnosis is made on physical examination and confirmed using |
cases , is self-resolving . No intervention — be it physiotherapy , podiatry with orthotics or surgical — is neces- |
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movement in joints that are essential |
plain X-rays . The key image is a rest- |
sary . While there is no good evidence |
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for hindfoot accommodation ( varus / valgus ) movements through the gait cycle — typically resulting in a rigid or non-correctable flat foot deformity . This deformity can become painful over time , particularly with periods of exertion . |
Tarsal coalition typically results in a rigid or non-correctable flat foot deformity that may become painful over time . |
ing lateral of the foot compared with a hyperplantarflexion lateral of the same foot .
If the position of the talus fails to correct to the normal anatomical alignment in the latter view , then the diagnosis of CVT can be made . Refer
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that physiotherapy or podiatry will alter the natural course of this condition , the judicious application of massage , topical anti-inflammatory gels and orthotics in cases where pain is an issue and without an insidious underlying cause , may be a useful |
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It is often more challenging to diag- |
early if there is any doubt about the |
adjunct to manage symptoms . Fami- |
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nose this condition in babies and tod- |
correct diagnosis or treatment for this |
lies will also feel ‘ something is being |
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dlers as the bony elements are yet to |
tive footwear and periods of rest must |
not only in a flat foot but a ‘ rocker |
condition . |
done ’. |
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ossify and cannot be appreciated on plain film X-ray . In the case of very young individuals , a ‘ watch-and-wait ’ |
be prescribed while awaiting surgical review . |
bottom ’ appearance , which may have implications in terms of the child ’ s ability to mobilise normally ( see fig- |
Management
In the majority of cases , the best
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While non-surgical treatment modalities may still have some role in this space , there is no good evidence |
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attitude may be taken until appropri- |
CONGENITAL VERTICAL TALUS |
ures 5 and 6 ). Gait is directly affected , |
treatment for paediatric foot and |
to suggest that aggressive treatment |
|
ate imaging and surgery can be safely |
As the name suggests , this is an |
with an inefficient and potentially |
ankle concerns is simply taking |
of this benign condition will result in |
|