Paediatrics / Foot and ankle
CVT and COT Paediatrics Foot and ankle
Congenital Oblique Talus
Talonavicular Subluxation : The talus and navicular are misaligned.Key Feature : This condition can be corrected by passive plantarflexion, which helps to differentiate it from Congenital Vertical Talus (CVT) .
Congenital Vertical Talus (CVT)
Aetiology
Congenital Irreducible Dorsal Dislocation of the Navicular Vertical Talus Orientation Severe Soft Tissue Contractures Occurs in 50% bilateral cases
50% associated with other congenital issues : Conditions like arthrogryposis, neuromuscular diseases, and myelodysplasia.
Clinical Features
Feature
Description
Disability Causes significant disability due to rigid foot structure.
Rigid Convex Sole The sole has a rounded, convex shape.
Valgus Hindfoot Outward angulation of the heel.
Rocker Bottom Foot The foot resembles a "Persian slipper" or rocker bottom.
Peg Leg Gait Stiff foot limits push-off, resulting in a peg leg gait.
Imaging
Lateral X-Ray in forced plantarflexion is diagnostic.Key Findings :
Navicular is dorsally dislocated.
Talus is not parallel to the calcaneus.
Talo-Calcaneal Angle : Increased to >40° (normal: 0-20°).Meary’s Angle : Increased to >20° (normal: 0-10°).
Management
Non-surgical management is ineffective. Surgical Options :
Open Reduction of talus and extensive soft tissue release, though may fail.Talectomy as a last resort.Triple Fusion as an alternative.
Related FRCS revision notes Written/reviewed by Kishore Puthezhath
Professor of Orthopaedics and Consultant Paediatric Orthopaedic Surgeon
FRCS (Tr & Orth) revision resource
Reviewed: September 2026
Core revision references: Miller's Review of Orthopaedics; Campbell's Operative Orthopaedics; Orthobullets . Current specialty guidelines are linked within individual notes where applicable.
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