Vertical Talus | Orthopaedics | Loyola Medicine

Vertical Talus

Overview and Facts about Vertical Talus

Vertical talus is an uncommon orthopaedic condition typically diagnosed at birth that causes flat feet in newborns. Diagnosis sometimes occurs during a prenatal ultrasound scan. Vertical talus may affect one foot or both feet. Although this condition does not cause any pain for the baby, if it is not treated promptly, it can cause discomfort and disability as the child grows older.

Signs and Symptoms of Vertical Talus

The talus bone is situated between the heel bone and the tibia and fibula. The latter two bones rest in front of and around the talus, forming the ankle joint. The talus allows distribution of weight throughout the ankle. In vertical talus, the talus bone is the wrong way around, causing the other bones that should be in front of the talus to rest on top of it. The foot points upward, giving it a “rocker bottom.” Signs include:

  • A foot flexed upward
  • An elevated heel
  • Improper alignment in the foot

Causes and Risk Factors of Vertical Talus

In most cases of vertical talus, the cause is unknown. It may be the result of chromosomal abnormalities that cause a neuromuscular disorder that disrupts the structure of the foot. Unfortunately, there is no way to prevent vertical talus.

Tests and Diagnosis of Vertical Talus

To diagnose vertical talus, a doctor performs a full physical examination to make sure that none of the child’s other joints are affected. To confirm the diagnosis, the doctor usually takes an X-ray of the affected foot or feet. Sometimes a CT scan or MRI is performed.

Treatment and Care for Vertical Talus

All children with vertical talus require treatment. Some children can be helped with non-surgical treatment, but others need surgery.

Non-surgical treatments include foot stretching exercises and casting of the midfoot and forefoot to reduce the upward curvature. Although these treatments improve the condition, the improvements may only be temporary.

Surgery for vertical talus is complicated because the foot’s movement must be corrected to allow it to move normally in three different directions. A surgeon who specializes in pediatric foot deformities typically performs the procedure.