Advertisement

Journal of Children's Orthopaedics

, Volume 6, Issue 4, pp 307–311 | Cite as

Primary outcomes of the congenital vertical talus correction using the Dobbs method of serial casting and limited surgery

  • Hossein AslaniEmail author
  • Ali Sadigi
  • Ali Tabrizi
  • Mohammadreza Bazavar
  • Mehdi Mousavi
Original Clinical Article

Abstract

Introduction

The traditional treatment for congenital vertical talus, which involves serial casting and extensive soft-tissue releases, has been associated with severe stiffness and other complications in adolescents and adults. Our hypothesis is that favorable results will be obtained using the Dobbs method of serial manipulation, casting, and limited surgery for vertical talus correction, even in older children and syndromic cases. Therefore, the present study aimed at evaluating the Dobbs method in such cases.

Materials and methods

We treated 15 feet of 10 patients (aged from 1 month to 9 years) using manipulation and serial casting or the reverse Ponseti method followed by percutaneous Achilles tenotomy and limited open reduction of the talonavicular joint. All patients were evaluated both clinically and radiologically in a mean follow-up period of 2 years.

Results

After 2 years, all patients had plantigrade and flexible feet with good radiographic correction. The mean talocalcaneal angle before (70.5° ± 10.5) and after (31° ± 5.2) treatment and the talar axis metatarsal base angle before (60° ± 11.4) and after (15° ± 6.7) treatment were significantly improved (P < 0.001).

Discussion

Recent research has shown that manipulation and serial casting followed by limited surgery (Dobbs method) was successful in treating idiopathic congenital vertical talus. Our results also showed that this method resulted in an excellent outcome in both idiopathic and syndromic congenital vertical talus, even in older children.

Keywords

Congenital vertical talus Casting Conservative treatment 

References

  1. 1.
    Jacobsen ST, Crawford AH (1983) Congenital vertical talus. J Pediatr Orthop 3:306–310CrossRefGoogle Scholar
  2. 2.
    Dodge LD, Ashley RK, Gilbert RJ (1987) Treatment of the congenital vertical talus: a retrospective review of 36 feet with long-term follow-up. Foot Ankle 7:326–332CrossRefGoogle Scholar
  3. 3.
    Hamanishi C (1984) Congenital vertical talus: classification with 69 cases and new measurement system. J Pediatr Orthop 4:318–326CrossRefGoogle Scholar
  4. 4.
    Ogata K, Schoenecker PL, Sheridan J (1979) Congenital vertical talus and its familial occurrence: an analysis of 36 patients. Clin Orthop Relat Res 139:128–132Google Scholar
  5. 5.
    Aroojis AJ, King MM, Donohoe M, Riddle EC, Kumar SJ (2005) Congenital vertical talus in arthrogryposis and other contractural syndromes. Clin Orthop Relat Res 434:26–32CrossRefGoogle Scholar
  6. 6.
    Campos da Paz AC Jr, de Souza V, de Souza DC (1978) Congenital convex pes valgus. Orthop Clin North Am 9:207–218Google Scholar
  7. 7.
    Clark MW, D’Ambrosia RD, Ferguson AB (1977) Congenital vertical talus: treatment by open reduction and navicular excision. J Bone Joint Surg Am 59:816–824Google Scholar
  8. 8.
    Coleman SS, Stelling FH 3rd, Jarrett J (1970) Pathomechanics and treatment of congenital vertical talus. Clin Orthop Relat Res 70:62–72Google Scholar
  9. 9.
    Colton CL (1973) The surgical management of congenital vertical talus. J Bone Joint Surg Br 55:566–574Google Scholar
  10. 10.
    Drennan JC (1996) Congenital vertical talus. Instr Course Lect 45:315–322Google Scholar
  11. 11.
    David MG (2011) Simultaneous correction of congenital vertical talus and talipes equinovarus using the Ponseti method. J Foot Ankle Surg 50(4):494–497CrossRefGoogle Scholar
  12. 12.
    Chalayon O, Adams A, Dobbs MB (2012) Minimally invasive approach for the treatment of non-isolated congenital vertical talus. J Bone Joint Surg Am 94(11):731–737CrossRefGoogle Scholar
  13. 13.
    Mazzocca AD, Thomson JD, Deluca PA, Romness MJ (2001) Comparison of the posterior approach versus the dorsal approach in the treatment of congenital vertical talus. J Pediatr Orthop 21:212–217Google Scholar
  14. 14.
    Eraltug U (1966) Corrective plaster application in the treatment of vertical talus. An analysis of eleven cases. Int Surg 46:246–249Google Scholar
  15. 15.
    Dobbs MB, Purcell DB, Nunley R, Morcuende JA (2006) Early results of a new method of treatment for idiopathic congenital vertical talus. J Bone Joint Surg Am 88:1192–1200CrossRefGoogle Scholar
  16. 16.
    Dobbs MB, Purcell DB, Nunley R, Morcuende JA (2007) Early results of a new method of treatment for idiopathic congenital vertical talus. Surgical technique. J Bone Joint Surg Am 89(2):111–121Google Scholar
  17. 17.
    Aydın A, Atmaca H, Müezzinoğlu US (2012) Bilateral congenital vertical talus with severe lower extremity external rotational deformity: treated by reverse Ponseti technique. Foot. doi: org/10.1016/j.foot.2012.04.004
  18. 18.
    Walker AP, Ghali NN, Silk FF (1985) Congenital vertical talus. The results of staged operative reduction. J Bone Joint Surg Br 67(1):117–121Google Scholar
  19. 19.
    Seimon LP (1987) Surgical correction of congenital vertical talus under the age of 2 years. J Pediatr Orthop 7:405–411CrossRefGoogle Scholar
  20. 20.
    Duncan RD, Fixsen JA (1999) Congenital convex pes valgus. J Bone Joint Surg Br 81:250–254CrossRefGoogle Scholar
  21. 21.
    Zorer G, Bagatur AE, Dogan A (2002) Single stage surgical correction of congenital vertical talus by complete subtalar release and peritalar reduction by using the Cincinnati incision. J Pediatr Orthop B 11:60–67Google Scholar
  22. 22.
    Alaee F, Boehm S, Dobbs MB (2007) A new approach to the treatment of congenital vertical talus. J Child Orthop 1:165–174CrossRefGoogle Scholar
  23. 23.
    Napiontek M (1995) Congenital vertical talus: a retrospective and critical review of 32 feet operated on by peritalar reduction. J Pediatr Orthop B 4:179–187CrossRefGoogle Scholar
  24. 24.
    Rodriguez N, Choung DJ, Dobbs MB (2010) Rigid pediatric pes planovalgus: conservative and surgical treatment options. Clin Podiatr Med Surg 27(1):79–92CrossRefGoogle Scholar
  25. 25.
    Eberhardt O, Fernandez FF, Wirth T (2011) Treatment of vertical talus with the Dobbs method. Z Orthop Unfall 149(2):219–224Google Scholar
  26. 26.
    Laaveg SJ, Ponseti IV (1980) Long-term results of treatment of congenital club foot. J Bone Joint Surg Am 62:23–31Google Scholar
  27. 27.
    Bhaskar A (2008) Congenital vertical talus: treatment by reverse Ponseti technique. Indian J Orthop 42(3):347–350CrossRefGoogle Scholar

Copyright information

© EPOS 2012

Authors and Affiliations

  • Hossein Aslani
    • 1
    Email author
  • Ali Sadigi
    • 1
  • Ali Tabrizi
    • 1
  • Mohammadreza Bazavar
    • 1
  • Mehdi Mousavi
    • 1
  1. 1.Department of Orthopedics, Shohada HospitalTabriz University of Medical ScienceTabrizIran

Personalised recommendations