Congenital vertical talus: a retrospective and critical review of 32 feet operated on by peritalar reduction.

Thirty-two feet in 23 children treated for congenital vertical talus by peritalar reduction have been evaluated. The age at operation ranged from 9 months to 8 years (mean 3.2 years). The follow-up ranged from 2.8 to 19.1 years (mean 9.2 years). In eight feet Green-Grice extraarticular subtalar arthrodesis was performed as part of a one-stage procedure. Eight of all operated feet required a second surgery 2.2 years after the first operation. In all the reoperated feet the Green-Grice arthrodesis was performed as well. Clinical examination found excellent results in five feet, good results in 12, fair results in nine, and poor results in six feet. The severe type of deformity, other abnormalities, and less extensive surgical procedures contributed to worse clinical results. Poor clinical results were associated with persistent equinus of the hindfoot, abduction of the forefoot, restriction of supination and eversion, and weakness of push-off power. X-ray examination showed excellent results in three feet, good in nine, fair in 13, and poor in seven feet. Poor radiological results were observed in children operated on after the fourth year of age. In most of the feet the navicular remained dislocated dorsally, dorsally and medially, and dorsally and laterally toward the head of the talus. A divergence between a relatively good appearance of the operated foot and a worse radiographic image has been observed. The Green-Grice extraarticular subtalar arthrodesis combined with the peritalar reduction method led to overcorrection in seven feet.