talonavicular

Congenital vertical talus

Definition

 

Rockerbottom foot / Persian Slipper Foot

 

Epidemiology

 

Uncommon

 

50% bilateral

 

Doesn't delay walking

- may present in toddler with callus under talus head

 

Associations

 

Congenital anomalies

- CNS disorders

- spina bifida & diastematomyelia ~10%

- arthrogryposis

- neurofibromatosis 

Subtalar and Triple Arthodesis

Biomechanics

 

Able to achieve relatively high level of function after STJ fusion

- previously believed that isolated STJ fusion should not be performed

- believed that triple arthrodesis was operation of choice for hindfoot

- STJ fusion has superior result with less stress on AJ

 

Average loss of DF 30% / PF 10%

 

Position of hindfoot determines flexibility of transverse tarsal (CCJ & TNJ) joints

- imperative that fusion be positioned in ~ 5o valgus