A 10-month-old boy has bilateral feet with a convex plantar surface, forefoot abducted and dorsiflexed, and the hindfoot in fixed equinus. The deformity is rigid and does not correct on manipulation. The most likely diagnosis is:
- A Congenital talipes equinovarus
- B Congenital vertical talus ✓
- C Calcaneovalgus foot
- D Metatarsus adductus
Correct answer: B. Congenital vertical talus
Explanation
Congenital vertical talus is a rigid flatfoot with a rocker-bottom sole: the talus is vertically oriented, the forefoot is abducted and dorsiflexed on the hindfoot, and the hindfoot is in equinus. This is the mirror image of clubfoot, in which the forefoot is adducted and supinated and the heel is in varus. Calcaneovalgus is flexible and self-limiting. Vertical talus requires reduction of the talonavicular joint, often by reverse Ponseti casting with percutaneous tendo-Achilles lengthening.
Reference: Tachdjian's Pediatric Orthopaedics, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.