Review Question - QID 815

Congenital vertical talus (CVT) is not associated with posteromedial bowing.

Congenital vertical talus (CVT) presents as a fixed rocker bottom foot. The hindfoot is in equinus and the forefoot is in dorsiflexion, producing a fixed midfoot dislocation through the talonavicular joint that does not correct with plantar flexion. CVT is a surgical problem that requires peritalar release to reduce the talonavicular and talocalcaneal articulations. Surgical treatment is required but preoperative casting can stretch the contracted tissues to facilitate surgery. Arthrodesis is not needed to correct deformity as soft tissue release and reduction have been shown to have acceptable results.

Drennan presents a Level 5 review article. In CVT, the talonavicular joint is irreducibly dislocated dorsally. CVT is usually associated with other congenital or neuromuscular abnormalities such as neural tube defects (myelomeningocele), neuromuscular disorders (arthrogryposis), malformation syndromes, and chromosomal aberrations.

Illustration A depicts the lateral radiograph demonstrating plantar flexion of an oblique (A) and vertical (B) talus. In the oblique talus, the navicular (unossified) and first metatarsus (and thus the talonavicular joint) line up in plantar flexion. In a true congenital vertical talus, the the navicular (unossified) and first MT remain dorsal to the talus in plantar flexion.

Incorrect Answer:
Calcaneovalgus foot is associated with posteromedial bowing of the tibia.