Alaee Farhang, Boehm Stephanie, Dobbs Matthew B
Department of Orthopaedic Surgery, Washington University School of Medicine, One Children s Place, Suite 4S20, St. Louis, MO, 63110, USA.
J Child Orthop. 2007 Sep;1(3):165-74. doi: 10.1007/s11832-007-0037-1. Epub 2007 Aug 1.
Congenital vertical talus is an uncommon foot deformity that is present at birth and results in a rigid flatfoot deformity. Left untreated the deformity can result in pain and disability. Though the exact etiology of vertical talus is unknown, an increasing number of cases have been shown to have a genetic cause. Approximately 50% of all cases of vertical talus are associated with other neuromuscular abnormalities or known genetic syndromes. The remaining 50% of cases were once thought to be idiopathic in nature. However, there is increasing evidence that many of these cases are related to single gene defects. Most patients with vertical talus have been treated with major reconstructive surgeries that are fraught with complications such as wound necrosis, talar necrosis, undercorrection of the deformity, stiffness of the ankle and subtalar joint, and the eventual need for multiple operative procedures. Recently, a new approach to vertical talus that consists of serial casting and minimal surgery has resulted in excellent correction in the short-term. Longer follow-up will be necessary to ensure maintenance of correction with this new technique. A less invasive approach to the correction of vertical talus may provide more favorable long-term outcomes than more extensive surgery as has been shown to be true for clubfoot outcomes.
先天性垂直距骨是一种罕见的足部畸形，出生时即存在，会导致僵硬扁平足畸形。若不治疗，该畸形会导致疼痛和残疾。尽管垂直距骨的确切病因尚不清楚，但越来越多的病例已显示出有遗传原因。所有垂直距骨病例中约50%与其他神经肌肉异常或已知的遗传综合征有关。其余50%的病例曾被认为本质上是特发性的。然而，越来越多的证据表明，这些病例中的许多与单基因缺陷有关。大多数垂直距骨患者接受了大型重建手术，但这些手术充满并发症，如伤口坏死、距骨坏死、畸形矫正不足、踝关节和距下关节僵硬，以及最终需要多次手术。最近，一种新的治疗垂直距骨的方法，包括连续石膏固定和微创手术，在短期内取得了良好的矫正效果。需要更长时间的随访以确保这种新技术能维持矫正效果。与更广泛的手术相比，一种侵入性较小的垂直距骨矫正方法可能会提供更有利的长期效果，正如在马蹄内翻足治疗结果中所显示的那样。
