Division of Paediatric Orthopaedics, Department of Orthopaedic Surgery, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
J Pediatr Orthop B. 2020 Jul;29(4):387-391. doi: 10.1097/BPB.0000000000000663.
Congenital vertical talus is a rare and complex foot anomaly. Serial casting with or without minimally invasive surgery is a universal management strategy especially for children in the first year of life. Nevertheless, extensive surgical treatment of late-presenting, neglected and multiple operated children with congenital vertical talus may be required with guarded results. The results of naviculectomy as a more conservative intervention and directed exclusively at ambulatory children with intractable congenital vertical talus have not been reported. We present the radioclinical outcomes of two ambulatory children with intractable congenital vertical talus treated by naviculectomy/midtarsal resection and limited soft tissue release. One child had an isolated congenital vertical talus whereas the other had a non-isolated etiology. Generally, naviculectomy/midtarsal resection revealed a positive benefit-risk profile in children with intractably severe congenital vertical talus on the short-term. We reported favorable results in terms of foot appearance, function and radiology. We believe that a less invasive procedure like naviculectomy/midtarsal resection is an encouraging technique to investigate in children with intractable congenital vertical talus.
先天性垂直距骨是一种罕见且复杂的足部畸形。连续铸型术（无论是否联合微创手术）是一种通用的治疗策略，特别是针对 1 岁以内的儿童。然而，对于迟发性、失治性和多次手术的先天性垂直距骨患儿，可能需要广泛的手术治疗，预后并不理想。作为一种更保守的干预措施，单纯针对有难治性先天性垂直距骨且可正常行走的儿童行跗舟骨切除术的效果尚未见报道。我们报告了 2 例采用跗舟骨切除术/跗横关节切除术联合有限软组织松解术治疗的难治性先天性垂直距骨患儿的放射临床疗效。1 例患儿为孤立性先天性垂直距骨，另 1 例患儿存在非孤立性病因。一般来说，对于严重先天性垂直距骨患儿，跗舟骨切除术/跗横关节切除术短期内的获益风险比为正性。我们的报告显示，患儿足部外观、功能和影像学结果均良好。我们认为，对于难治性先天性垂直距骨患儿，跗舟骨切除术/跗横关节切除术等微创术式是一种很有前途的治疗技术。
