ABSTRACT
Congenital vertical talus is a rare foot deformity that is considered a rigid form of flatfoot. Congenital vertical talus is characterised by a dislocation of the talonavicular joint, with the navicular displaced dorsally and the head of the talus pointing plantarward. The heel is in equinus and valgus, the forefoot dorsiflexed and abducted producing, in severe cases, a convex border to the sole or a ‘rocker bottom’ foot. Abnormal muscle biopsies are common in patients with congenital vertical talus and there are associations to arthrogryposis, multiple pterygium syndrome, and chromosome anomalies such as trisomy 18. Early use of non-operative treatment in combination with limited surgery is a general principle in the management of some of the more enigmatic congenital foot conditions, for example clubfoot, and now with congenital vertical talus. Surgeons need to be able to distinguish subtler forms of congenital vertical talus from flexible flatfoot or the oblique talus and apply the strategy appropriately.
