Objective: To evaluate the surgical efficacies of one-stage comprehensive soft-tissue release and peritalar reduction incorporating tibialis anterior transfer (CSTR-PTR-TAT) in patients with congenital vertical talus (CVT) before the age of 4 years.
Methods: Thirty-five feet of 21 children with true congenital vertical talus were underwent one-stage CSTR-PTR-TAT. The male-to-female ratio was 2.5: 1. Twenty-three percent (5 patients with 8 feet) belonged to isolated CVT and the remainder CVT associated with other congenital or neuromuscular abnormalities. The mean operative age was 30.1 (12-48) months. All patients were available for clinical and radiological follow-ups for a mean period of 3.5 (1.5-7) years.Kodros scoring system was utilized for assessment of final outcomes.
Results: The outcomes of 3 feet (9%) were excellent, 27 (77%) good and 5 (14%) fair. All patients wore normal shoes and were satisfied by their functional results and appearance. The patients with fair results were associated with arthrogryposis. No talar avascular necrosis was encountered.None required further operation.Radiologically there was a statistically significant postoperative improvement of measured angles compared to preoperative values (P < 0.05). All radiological parameters were within normal ranges. There was no difference of post operative angles compared to those at the final follow-up (P > 0.05).
Conclusion: As a complex deformity usually associated with other congenital or neuromuscular abnormalities, CVT may be satisfactorily managed with one-stage correction by CSTR-PTR-TAT before the age of 4 years.