Review Article
Volume 11 Issue 3 - 2020
Long-Term Results of Treatment of Children with Congenital Vertical Talus in Russia
Gromov IV1*, Vavilov MA1, Soloveva EN1 and Sokolov AG2
1The Regional Children's Clinical Hospital, Yaroslavl, Russian Federation
2Federal State Budgetary Educational Institution of Higher Education "Yaroslavl State Medical University" of the Ministry of Healthcare of the Russian Federation
*Corresponding Author: Gromov IV, The Regional Children's Clinical Hospital, Yaroslavl, Russian Federation.
Received: January 22, 2020; Published: February 11, 2020




Abstract

Introduction: According to various authors the frequency of the vertical position of the talus is 1 per 10 000 newborns.

Objective: To study the long-term results of treatment of feet with congenital vertical talus, treated by means of the classical techniques of treatment and the minimally invasive approach of M. Dobbs.

Materials and Methods: 30 clinical impressions (54 feet) with serious congenital flat-valgus deformities of the feet were analyzed for 11 years. The age of patients at the beginning of treatment varied from 1 month to 13 years. Primarily, 54 operations were performed to them. Three-articular arthrodesis - 2, open reduction of the talus bone by S.J. Kumar, K.R. Cowell, D.L. Ramsey - 5, open reduction of the talus by Colleman with bonding - 6, serial casting and percutaneous fixation of the Talo-navicular joint with K-wire with Achilles tentotomy - 41. In these conditions, the reduction of the talus bone of 23 feet was carried out under control of the eye with capsuloplasty, in other cases it was closed under the C-arm.

Results: According to the analysis the most beneficial results were those results of treatment of 21 children (41 feet) who at an early age had an approach M. Dobbs, including a serial casting in combination with minimally invasive surgical procedures and the further wearing of braces. Despite the initial decentish correction in the course of growth (on average 6.1 years) there were relapses of the vertical talus (3 children - 4 feet) to the level of transverse talus and the case of a complete loss of correction results, which required follow-up surgery. However, the need for open reduction of the talus bone in this patient’s population in our clinic has significantly decreased after introduction of the M. Dobbs method. In addition, there are more and more cases of successful primary treatment by Dobbs method in the national literature and long-term results in our country are not yet presented.

Conclusion: Method of Dobbs demonstrates its effectiveness. Surgical intervention according to the methods of Kumar and Coleman are rescue therapy for children whose feet deformity was revealed late or recurred due to the lack of efficacy of the Dobbs methods. Triple arthrodesis as a definitive surgery can be used in case of late detection of pathology or poor results.

Keywords: vertical Talus; Flatfoot; Dobbs’ Method; Foot Deformity

References

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Citation: Gromov IV., et al. “Long-Term Results of Treatment of Children with Congenital Vertical Talus in Russia”. EC Orthopaedics 11.3 (2020): 01-10.

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