Vertical Talus

Vertical talus is a congenital foot disorder, meaning it is present at the time of birth. It appears as an extreme case of flatfoot and may affect one or both feet. Though vertical talus is not painful for a newborn or young child, it can lead to serious problems and discomfort later in life. The talus is a small bone that connects the foot and leg, and sits between the heel bone (calcaneus) and the two bones of the lower leg (tibia and fibula). The tibia and fibula work with the talus to form the ankle joint. In vertical talus, the talus has formed in the wrong position and other foot bones have formed on top of the talus. As a result, the foot typically points up and the bottom of the foot is stiff with no arch.

Causes and Risk Factors

The exact cause of vertical talus is not known, though it is often associated with the following conditions:

  • Arthrogryposis
  • Spina bifida
  • Neurofibromatosis
  • Other neuromuscular diseases

Symptoms

Vertical talus is usually diagnosed at birth, or before, if it is visible on an ultrasound.

Treatment

Vertical talus will not resolve itself and requires medical attention. It is important for vertical talus to be treated early before the deformity has time to progress. If your child learns to walk with an abnormal foot, painful problems can develop. Nonsurgical treatment options for vertical talus include:

  • Stretching or casting
  • Physical therapy

If the deformity does not correct with conservative treatment, surgery is usually required. Your pediatric orthopedic surgeon will put the bones in the correct position and fix any issues with the tendons and ligaments supporting the bones. A brace or special shoe may be recommended to prevent the deformity from returning. With treatment, you can expect your child to have a stable and functional foot.