Experience in the treatment of infantile talus deformity lfatfoot
CAI Hao-qi
WANG Zhi-gang
CAI Hai-qing
GE Yi-hua
Abstract：Objective To introduce the key points to identify the vertical talus and oblique talus, and discuss the treatment.Methods According to the X-ray and clinical findings, two types of deformity were identified and corresponding treatment was given in 22 patients ( 28 feet ). Through the physical examination ( for example, the Achilles tendon ) and X-ray measurement of TCA & CPA & T1MT, type and severity of the disease could be evaluated. In vertical talus of max plantar lfexion in lateral radiograph, there were talo-navicular and calcaneo-cuboid dislocations. In oblique talus of max plantar lfexion in lateral radiograph, there were no talo-navicular or calcaneo-cuboid dislocations. Six vertical talus feet were all inflexible flatfeet, which had to be treated by extensive soft tissue release and open reduction even with a calcaneus lengthening. Twenty-two oblique talus feet were flexible flatfeet with Achilles tendon contracture, accepting the Achilles tendon lengthening and reduction of the talus. In the follow-up, the X-ray was measured again and the Maryland foot score was used for evaluation.Results The mean follow-up period was 31 months. The 6 vertical talus feet gained more than 9 points by Walker system. And the 22 oblique talus feet were all excellent or ifne by Maryland system. For 5 vertical talus on lateral radiograph: TCA was reduced from 83.1° to 51.3°, CPA was from-20.1° to 1.3°, and T1MT was from 85.3° to 30.6°. And in Maryland system: 2 excellent, 1 good, 2 fair. For 17 oblique talus on lateral radiograph: TCA was reduced from 58.2° to 35.3°, CPA was from-5.3° to 15.6°, T1MT was from 42.3° to 9.7°. And in Maryland system, 15 excellent, 2 good.Conclusions Accurate identiifcation and proper treatment are critical to obtain good results. Oblique talus is lfexible lfatfoot with contracture of Achilles tendon, and vertical talus is rigid lfatfoot. Both of them can be identiifed by physical and imaging examination. Early active treatment are needed. Series cast, Achilles tendon lengthening, closed reduction and internal ifxation are mainly used in the treatment of children with oblique talus. The treatment of vertical talus varies according to the age of the children, including series cast, Achilles tendon lengthening, closed reduction and internal ifxation, extensive soft tissue release and calcaneus lengthening.
Keywords：InfantChildpreschoolTalusFoot deformitiesFlatfoot
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 760-765 )