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Talus verticalis

Aktuelle Diagnose- und Therapieoptionen

Vertical talus

Current diagnostic and therapy options

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Zusammenfassung

Der Talus verticalis ist eine seltene, angeborene Deformität des Fußes, die isoliert oder in Assoziation mit anderen Fehlbildungen auftritt. Pathoanatomisch liegt eine Luxation des Talonavikulargelenks und des subtalaren Gelenks vor. Ätiologie und Pathogenese der Fehlbildung sind weiterhin nicht abschließend geklärt, wobei für wenige Fälle eine genetische Komponente nachgewiesen werden konnte. Klinisch imponieren eine konvexe Ausbildung der kindlichen Fußsohle (Schaukelfuß), eine Abduktion und Extension des Vorfußes sowie ein Fersenhochstand bei Achillessehnenverkürzung. Die Diagnose wird durch die konventionelle Röntgenuntersuchung des Fußes gesichert. Differenzialdiagnostisch sollte eine Abgrenzung zum flexiblen Plattfuß, sekundären neurogenen Knick-Senk-Fuß, Talus obliquus und Hackenfuß erfolgen. Die Behandlung des Talus verticalis strebt eine physiologische Rekonstruktion der anatomischen Verhältnisse an, um damit einen schmerzfreien, funktionell gut belastbaren Fuß zu schaffen. Die operative Behandlung erzielt gute Ergebnisse, ist jedoch mit intra- und postoperativen Komplikationen assoziiert. Gute Kurzzeitergebnisse einer modifizierten, konservativen Behandlung mittels Reposition, Gipsredression und minimal-invasiver Maßnahmen könnten, ähnlich der Behandlung des Klumpfußes, zu einem Wandel im Therapiekonzept des Talus verticalis führen.

Abstract

Congenital vertical talus is a rare condition which presents as an isolated deformity or in association with neuromuscular and/or genetic disorders. Pathoanatomically the deformity shows a dislocated talonavicular and subtalar joint. The etiology and pathogenesis are still not finally determined although in some cases a genetic basis has been identified. The clinical picture is that of a flat, convex longitudinal arch with abduction and dorsiflexion of the forefoot and an elevated heel. Clinical diagnosis is confirmed by plain radiographic imaging. Congenital vertical talus should not be confused with other deformities of the foot, such as congenital oblique talus, flexible flat feet or pes calcaneus. The object of treatment of congenital vertical talus is to restore a normal anatomical relationship between the talus, navicular and calcaneus to obtain a pain-free foot. Major reconstructive surgery has been reported to be effective but is associated with substantial complications. Good early results of a modified non-operative treatment using serial manipulation, cast treatment and minimally invasive surgery may change therapeutic concepts.

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Literatur

  1. Aydın A, Atmaca H, Müezzinoğlu ÜS (2012) Bilateral congenital vertical talus with severe lower extremity external rotational deformity: treated by reverse Ponseti technique. Foot 22(3):252–254

    Article  Google Scholar 

  2. Bhaskar A (2008) Congenital vertical talus: treatment by reverse ponseti technique. Indian J Orthop 42(3):347–350

    Article  PubMed  Google Scholar 

  3. Campos da Paz AC Jr, Souza V de, Souza DC de (1978) Congenital convex pes valgus. Orthop Clin North Am 9:207–218

    Google Scholar 

  4. 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):e73.1–7

    Google Scholar 

  5. Coleman SS, Stelling FH 3rd, Jarrett J (1979) Pathomechanics and treatment of congenital vertical talus. Clin Orthop Relat Res 70:62–72

    Google Scholar 

  6. Dobbs MB, Gurnett CA, Pierce B et al (2006) HOXD10 M319K mutation in a family with isolated congenital vertical talus. J Orthop Res 24:448–453

    Article  PubMed  CAS  Google Scholar 

  7. Dobbs MB, Gurnett CA, Robarge J et al (2005) Variable hand and foot abnormalities in family with congenital vertical talus and CDMP-1 gene mutation. J Orthop Res 23:1490–1494

    PubMed  CAS  Google Scholar 

  8. Dobbs MB, Purcell DB, Nunley R (2006) Early results of new method of treatment for idiopathic congenital vertical talus. J Bone Joint Surg [Am] 88:1192–1200

    Google Scholar 

  9. Dobbs MB, Schoenecker PL, Gordon JE (2002) Autosomal dominant transmission of isolated congenital vertical talus. Iowa Orthop J 22:25–27

    PubMed  Google Scholar 

  10. Drennan JC (1995) Congenital vertical talus. J Bone Joint Surg [Am] 77:1916–1923

    Google Scholar 

  11. Duncan RD, Fixsen JA (1999) Congenital convex pes valgus. J Bone Joint Surg 81:250–254

    Article  CAS  Google Scholar 

  12. Eberhardt O, Fernandez FF, Wirth T (2011) Die Behandlung des Talus verticalis in der Methode nach Dobbs. Z Orthop Unfall 149:2219–2224

    Google Scholar 

  13. Giannestras NJ (1970) Recognition and treatment of flatfeet in infancy. Clin Orthop Relat Res 70:10–29

    PubMed  CAS  Google Scholar 

  14. Greenberg AJ (1981) Congenital vertical talus and congenital calcaneovalgus deformity: a comparison. J Foot Surg 4:189–193

    Google Scholar 

  15. Hamanishi C (1984) Congenital vertical talus: classification with 69 cases and new measurement system. J Pediatr Orthop 4:318–326

    Article  PubMed  CAS  Google Scholar 

  16. Harrold AJ (1967) Congenital vertical talus in infancy. J Bone Joint Surg [Br] 49:634–643

    Google Scholar 

  17. Hefti F, Brunner R (1999) Das abgeflachte Fußgewölbe. Orthopäde 28:159–172

    PubMed  CAS  Google Scholar 

  18. Jacobsen ST, Crawford AH (1983) Congenital vertical talus. J Pediatr Orthop 3:306–310

    Article  PubMed  CAS  Google Scholar 

  19. Klein DM, Merola AA, Spero CR (1996) Congenital vertical talus with a talocalcaneal coalition. J Bone Joint Surg [Br] 78(2):326–327

    Google Scholar 

  20. Kodros SA, Dias LS (1999) Single-stages surgical correction of congenital vertical talus. J Pediatr Orthop 19:42–48

    PubMed  CAS  Google Scholar 

  21. Krauspe R, Raab P (2000) Die Operation des Talus verticlais congenitus. Oper Orthop Traumatol 12:154–170

    Article  Google Scholar 

  22. Lombardi CM, Silver LM, Silhanek AD (2001) Treatment of congenital convex pes valgus with navicular excision and subtalar arthroereisis: a case study. J Foot Ankle Surg 40:166–171

    Article  PubMed  CAS  Google Scholar 

  23. Napiontek M (1995) Congenital vertical talus. A retrospective and critical review of 32 feet operated on by peritalar reduction. J Pediatr Orthop B-4:179–187

    Google Scholar 

  24. Ogata K, Schoenecker PL, Sheridan J (1979) Congenital vertical talus and its familial occurrence: an analysis of 36 patients. Clin Orthop Relat Res 139:128–132

    PubMed  Google Scholar 

  25. Ritsilä VA (1969) Talipes equinovarus and vertical talus produced experimentally in newborn rabbits. Acta Orthop Scand(Suppl) 121:1–98

    Google Scholar 

  26. Schlesinger AE, Deeney VF, Caskey PF (1989) Sonography of the nonossified tarsal navicular cartilage in an infant with congenital vertical talus. Pediatr Radiol 20:134–135

    Article  PubMed  CAS  Google Scholar 

  27. Schwering L (2005) Operative Korrektur des echten Talus verticalis. Oper Orthop Traumatol 17:211–231

    Article  PubMed  Google Scholar 

  28. Seimon LP (1987) Surgical correction of congenital vertical talus under the age of 2 years. J Pediatr Orthop 7:405–411

    Article  PubMed  CAS  Google Scholar 

  29. Sharrard WJ, Grosfield I (1968) The management of deformity and paralysis of the foot in myelomeningocele. J Bone Joint Surg [Br] 50:456–465

    Google Scholar 

  30. Silk FF, Wainwright D (1967) The recognition and treatment of congenital flatfeet in infancy. J Bone Joint Surg [Br] 49:628–633

    Google Scholar 

  31. Stern HJ, Clark RD, Stroberg AJ, Shohat M (1989) Autosomal dominant transmission of isolated congenital vertical talus. Clin Genet 36:427–430

    PubMed  CAS  Google Scholar 

  32. Striker SJ, Rosen E (1997) Early reconstruction of congenital vertical talus. Foot Ankle Int 18:535–543

    Article  Google Scholar 

  33. Violas P, Chapuis M, Tréguier C et al (2006) Ultrasound: a helpful technique in the analysis of congenital vertical talus. A case report. J Pediatr Orthop B-15(1):70–72

    Google Scholar 

  34. Walker AP, Ghali NN, Silk FF (1985) Congenital vertical talus. The results of staged operative reduction. J Bone Joint Surg 67:117–121

    CAS  Google Scholar 

  35. Wirth T, Schuler P, Griss P (1994) Early surgical treatment for congenital vertical talus. Arch Orthop Trauma Surg 113:248–253

    Article  PubMed  CAS  Google Scholar 

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  1. Klinik für Orthopädie, Universitätsklinikum Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland

    D. Arbab, B. Rath, V. Quack, C. Lüring & M. Tingart

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  1. D. Arbab
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  2. B. Rath
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  3. V. Quack
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  4. C. Lüring
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  5. M. Tingart
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Correspondence to D. Arbab.

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Arbab, D., Rath, B., Quack, V. et al. Talus verticalis. Orthopäde 42, 402–408 (2013). https://doi.org/10.1007/s00132-013-2089-x

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