Curso de instrucción: astrágalo vertical congénito: protocolo terapéutico

Congenital vertical talus is a rare deformity of the foot that is present at birth and is characterized by a rigid flat foot produced by an irreducible dislocation of the navicular and the talus. Without a treatment, the deformity itself will cause a functional disability as a result of a painful stance phase during walking. The diagnosis is usually performed by a physical exam of the patient and confirmed by dynamic x-ray films, where the irreducible dislocation of the talus-navicular joint should be showed. Because of the existence of many different etiological factors, variable degrees of rigidity, and complexity of morphological and mechanical changes in the foot, a large number of treatments had been designed to treat it. Most of them with acceptable results as they were previously reported on many case series, almost all with a small number of patients. Herein, we propose a rationale for treatment, mainly based on age group classification of the pathology, whereas the deformity will progressively become rigid, and where further adaptive bone deformities will along time be developed and considered. Hopefully, this rationale for treatment may provide favorable long-term results beneath each group, specially when an extensive surgery will have to be performed.