eMedicine Specialties > Orthopedic Surgery > Pediatrics

Congenital Vertical Talus: Workup

Author: Jeffrey D Thomson, MD, Assistant Professor, Department of Orthopedic Surgery, University of Connecticut; Director of Orthopedic Surgery, Department of Pediatric Orthopedic Surgery, Connecticut Children's Medical Center
Contributor Information and Disclosures

Updated: Mar 20, 2007

Workup

Imaging Studies

  • Radiographs
    • Weightbearing anteroposterior and lateral views of the foot are the first radiographs that need to be obtained.
    • A lateral radiograph with the foot in maximum plantarflexion is mandatory to confirm a vertical talus.
    • Because the navicular may not be ossified, the alignment of the first metatarsal to the talus must be evaluated.
    • In a vertical talus, the metatarsal does not line up with the talus. Lines drawn through the long axis of the first metatarsal and the talus converge on the plantar aspect of the foot.
    • Hamanishi (1984) described 2 radiographic angles: the talar axis–first metatarsal base angle (TAMBA) and the calcaneal axis–first metatarsal base angle (CAMBA). The changing point from a flexible oblique talus to rigid CVT is a TAMBA of approximately 60° and a CAMBA of 20°.
  • Magnetic resonance imaging of the spine may be indicated if an occult spinal dysraphism, such as lipomeningocele, is suspected. Posterior and lateral lumbar spine radiographs also may be useful to exclude occult spinal dysraphism.

More on Congenital Vertical Talus

Overview: Congenital Vertical Talus
Workup: Congenital Vertical Talus
Treatment: Congenital Vertical Talus
Follow-up: Congenital Vertical Talus
References
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References

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  2. Coleman SS, Stelling FH 3rd, Jarrett J. Pathomechanics and treatment of congenital vertical talus. Clin Orthop Relat Res. May-Jun 1970;70:62-72. [Medline].

  3. Dobbs MB, Purcell DB, Nunley R, et al. Early results of a new method of treatment for idiopathic congenital vertical talus. J Bone Joint Surg Am. Jun 2006;88(6):1192-200. [Medline].

  4. Dodge LD, Ashley RK, Gilbert RJ. Treatment of the congenital vertical talus: a retrospective review of 36 feet with long-term follow-up. Foot Ankle. Jun 1987;7(6):326-32. [Medline].

  5. Drennan JC. Congenital vertical talus. Instr Course Lect. 1996;45:315-22. [Medline].

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  7. Eyre-Brook AL. Congenital vertical talus. J Bone Joint Surg Br. Nov 1967;49(4):618-27. [Medline]. [Full Text].

  8. Hamanishi C. Congenital vertical talus: classification with 69 cases and new measurement system. J Pediatr Orthop. May 1984;4(3):318-26. [Medline].

  9. Herndon CH, Heyman CH. Problems in the recognition and treatment of congenital pes valgus. J Bone Joint Surg Am. 1963;45:413-29.

  10. Jacobsen ST, Crawford AH. Congenital vertical talus. J Pediatr Orthop. Jul 1983;3(3):306-10. [Medline].

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  13. Mazzocca AD, Thomson JD, Deluca PA. Comparison of the posterior approach versus the dorsal approach in the treatment of congenital vertical talus. J Pediatr Orthop. Mar-Apr 2001;21(2):212-7. [Medline].

  14. Ogata K, Schoenecker PL, Sheridan J. Congenital vertical talus and its familial occurrence: an analysis of 36 patients. Clin Orthop Relat Res. Mar-Apr 1979;(139):128-32. [Medline].

  15. Osmond-Clarke H. Congenital vertical talus. J Bone Joint Surg Br. Feb 1956;38-B(1):334-41. [Medline].

  16. Seimon LP. Surgical correction of congenital vertical talus under the age of 2 years. J Pediatr Orthop. Jul-Aug 1987;7(4):405-11. [Medline].

  17. Stricker SJ, Rosen E. Early one-stage reconstruction of congenital vertical talus. Foot Ankle Int. Sep 1997;18(9):535-43. [Medline].

  18. Sullivan JA. Pediatric flatfoot: evaluation and management. J Am Acad Orthop Surg. Jan 1999;7(1):44-53. [Medline].

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Further Reading

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Keywords

CVT, congenital convex pes valgus, congenital rigid rocker-bottom foot, flatfoot, Persian slipper, dislocated navicular, oblique talus

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Contributor Information and Disclosures

Author

Jeffrey D Thomson, MD, Assistant Professor, Department of Orthopedic Surgery, University of Connecticut; Director of Orthopedic Surgery, Department of Pediatric Orthopedic Surgery, Connecticut Children's Medical Center
Jeffrey D Thomson, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Mininder S Kocher, MD, MPH, Associate Professor of Orthopedic Surgery, Harvard Medical School/Harvard School of Public Health; Associate Director, Division of Sports Medicine, Department of Orthopedic Surgery, Children's Hospital Boston
Mininder S Kocher, MD, MPH is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for the History of Medicine, American Medical Association, American Orthopaedic Society for Sports Medicine, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

George H Thompson, MD, Professor of Orthopedic Surgery and Pediatrics, Department of Pediatric Orthopedic Surgery, Case Western Reserve University; Director, Rainbow Babies and Children's Hospital
George H Thompson, MD is a member of the following medical societies: American Academy for Cerebral Palsy and Developmental Medicine, American Academy of Orthopaedic Surgeons, American Academy of Pediatrics, and Ohio State Medical Association
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Dennis P Grogan, MD, Clinical Professor, Department of Orthopedic Surgery, University of South Florida College of Medicine; Chief of Staff, Department of Orthopedic Surgery, Shriners Hospital for Children of Tampa
Dennis P Grogan, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Eastern Orthopaedic Association, Irish American Orthopaedic Society, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society
Disclosure: Nothing to disclose.

 
 
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