PAEDIATRIC FOOT AND ANKLE DISORDERS

10 Nov PAEDIATRIC FOOT AND ANKLE DISORDERS

Congenital vertical talus

• Fixed dislocation of talonavicular joint producing rigid flat foot deformity(convex foot deformity)
• Associated with neuromuscular disorder
• can be idiopathic
• clinically looks like calcaneovalgus but the deformity is at mid foot.
• components
  • Fixed hind foot equinovalgus
  • Rigid mod foot dorsiflexion
  • Forefoot abduction and dorsiflexion
• PATHOANATOMY:
  • Talus plantar flexed and the navicular articulates with dorm of talus
• X-RAYS:
  • MEARY’S angle angle between talus and 1st metatarsal longitudinal axis ( 0-4 normal)
  • Forced plantar flexion view shows persistent dorsal dislocation of talonavicular joint with talus parallel to tibia.
• TREATMENT
  • Serial manipulation and casting for 3 months to stretch contracted dorsal and lateral soft tissue.
  • Reverse ponsetti
  • TA, EHL, EDL And peroneals release and talonavicular reduction and pinning.