Surgical treatment of congenital vertical talus at Soba University Hospital

Shaheen S., Mohamed A.E. M.

Abstract


Background: Congenital Vertical talus (CVT) is a rare abnormality that can be either idiopathic, part of
multiple abnormalities or part of a syndrome. There are many systems of classification and methods of
conservative and surgical management and outcome scoring systems in the literature.
Materials and Methods: Between 2005 and 2014, 40 feet of 30 patients with congenital vertical talus
were surgically treated in the department of orthopaedics at Soba University Hospital. All were operated on
by the first author; using single stage three incisions technique. Preoperative and postoperative radiographic
measurements adopted were those of Abdel-Razzak and Vanderwilde et.al. The outcome scoring system
used was the modified Walker’s 32 points scoring system.
Results: There were 19 males and 11 females. Their ages ranged between 8 and 72 months (mean 30.4).
Patients were grouped into two groups; group A from birth to 2yrs, which include 19 patients (47.5%),
group B more than 2 years including the remaining 21 (52.5%). Ten patients (33.3%) had idiopathic CVT
and 20 (66.7%) patients had non-idiopathic CVT mainly secondary to arthrogryposis (77.8%). All patients
were available for clinical and radiological follow up for a mean of 44.8 months. 23 feet (57.5%) had
excellent results, 7 (17.5%) good, 3 (7.5%) fair and 7 feet (17.5%) had poor results. The mean score for all
patients was 31.95 points.
Radiologically there was a statistically significant improvement of the measured angles at the final followup
compared to the preoperative angles.
Unsatisfactory results occurred in 10 feet (25%); nine of these (90%) were due to secondary CVT, 7 (77.8%)
associated with arthrogryposis. Six feet (60%) were in older age group while 4 feet (40%) were in the
younger age group. One case of talar avascular necrosis was encountered in this study.
Conclusion: CVT is a rare abnormality. Early treatment is associated with better outcome.

Keywords


Surgical; treatment; congenital; vertical; talus; Soba; University; Hospital

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