Congenital vertical talus and its familial occurrence: an analysis of 36 patients.

Thirty-six patients (57 feet) showing congenital vertical talus were treated at the St. Louis Unit of the Shriners Hospital between 1958 and 1978. A high incidence of congenital hip dislocatiom, arthrogryposis, congenital hypoplasia of tibia and CNA disorders was noted as associated abnormalities. These patients are classified in 3 groups: (I) primary isolated form (16 patients); (II) associated form without neurological deficit (12 patients); (III) associated form with neurological deficit (8 patients). Fifty per cent of the patients with primary isolated form had positive family history of foot deformities in their first degree relatives. Familial incidence of congenital vertical talus was observed in 2 families studied. Genetic factors may play an important role in the etiology of the primary isolated form of congenital vertical talus. The current treatment is a one-stage open reduction of the talonavicular dislocation, combined with a posterior release. A subtalar bone block is often imperative to maintain correction. Cast correction alone has never succeeded as the definitive treatment of this condition.