What are the other Names for this Condition? (Also known as/Synonyms)

• Congenital Convex Pes Valgus
• Congenital Vertical Talus (CVT)
• Rocker-Bottom Foot Deformity 

What is Vertical Talus? (Definition/Background Information)

• The talus bone, also referred to as the anklebone, is part of a group of small bones that are located between the heel bone and the two bones of the lower leg (fibula and tibia)
• Vertical Talus is a very rare congenital deformity of the foot that is diagnosed at birth (congenital onset). This deformity is one of the major causes of flatfeet in newborns
• Although the most common method to treat Congenital Vertical Talus (CVT) is surgery, a physician may recommend a series of nonsurgical treatment measures. The nonsurgical treatment methods include a combination of stretching and casting, designed to increase flexibility of the foot, and in some cases correct the deformity
• If left untreated, Vertical Talus may eventually lead to severe disability and discomfort for the child 

Who gets Vertical Talus? (Age and Sex Distribution)

• Vertical Talus is a congenital deformity affecting the feet
• Both male and female infants can develop the condition
• There is no particular racial or ethnic preference noticed 

What are the Risk Factors for Vertical Talus? (Predisposing Factors)

• Currently, there are no known risk factors for the development of Vertical Talus 

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Vertical Talus? (Etiology)

• The exact cause of Vertical Talus is unknown
• Some researchers believe that this rare deformity may be associated with myelodysplasia, arthrogryposis, trisomy, sacral agenesis, spina bifida, and neurofibromatosis
• Vertical Talus may also be associated with developmental dysplasia of the hip (DDH) 

What are the Signs and Symptoms of Vertical Talus?

Common sign and symptoms associated with a Vertical Talus include:

• The foot curves upward and the arch of the foot is reversed. Hence, this condition is also known as 'Rocker-Bottom Foot'
• Due to the reverse curvature of the foot, it is difficult to apply force to a surface, such as while walking or running
• Formation of a painful thick skin layer (callus) on the bottom of the foot
• Rigid flat surface of the foot
• Equinus deformity (limited upward bending of ankle), due to a heel bone defect 

How is Vertical Talus Diagnosed?

Vertical Talus is diagnosed using the following tools:

• A thorough physical examination and complete medical history
• X-ray of the foot: X-rays can help a physician determine the severity of the deformity, and if the foot can be manually manipulated back into a normal position 

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Vertical Talus?

Complications of a Vertical Talus may include:

• Complications from surgery, such as:
  • Wound infection
  • Recurrence of the deformity
  • Under or over correction of the abnormality
  • Stiffness of the ankle joint
  • Avascular necrosis of talus
• Requirement of extensive (often multiple) surgeries at a very young age, to correct the foot defect may be necessary, depending the extent of the deformity
• Permanent disability and difficulty movement, without any treatment 

How is Vertical Talus Treated?

Although the most common method to treat Vertical Talus is by surgery, a physician may initially recommend a series of non-surgical treatments, such as:

• A combination of stretching and casting design (known as the Ponseti method) to increase flexibility within the foot; in some cases, it can help correct the deformity
• Even when the deformity is corrected through the Ponseti method, Vertical Talus is likely to relapse. For this very reason, parents play an important role in the success of the treatment, by closely following the directions for bracing and stretching that is given by the healthcare provider
• Parents of the child should also note that with any casting, bracing, or stretching program, changes within the temperature and color of the child’s foot may indicate a poor circulation of blood 

If conservative methods are not successful in correcting Congenital Vertical Talus, the physician may recommend surgery, when the infant is around 9-12 months of age.

• The surgical procedure is performed to correct all parts of the deformity, which includes the bones of the foot, as well as the ligaments and tendon that provide support to the bones
• During the procedure, the physician manipulates the bones into the correct position, and uses pins to hold them in place. The affected ligaments and tendons of the foot may have to be shortened 

How can Vertical Talus be Prevented?

• Currently, there are no specific methods or guidelines to prevent Vertical Talus
• Active research is currently being performed to identify tissue abnormalities and congenital causes responsible for Vertical Talus. This has the possibility to lead to improved treatment methods and preventative techniques 

What is the Prognosis of Vertical Talus? (Outcomes/Resolutions)

• The long-term prognosis of infants with Vertical Talus is usually good, if detected and treated early
• Without treatment, this condition will most likely cause permanent disability and pain for the individual
• A healthcare professional will likely recommend several visits to the clinic over many years, in order to monitor the growth and development of the child’s foot 

Additional and Relevant Useful Information for Vertical Talus:

Approximately, 1 in 10,000 infants are born with Vertical Talus. In approximately half of these cases, both feet are affected.