This 2015 narrative review by Miller and Dobbs covers congenital vertical talus (CVT) — a rare, rigid rocker-bottom flatfoot caused by fixed dorsal dislocation of the navicular on the talus — addressing its epidemiology, genetic and neuromuscular etiology, pathoanatomy, radiographic diagnosis, classification, and the evolution from extensive surgical release toward a minimally invasive casting-based approach.
When you see a rigid rocker-bottom flatfoot in a newborn, confirm hindfoot equinus is present (its absence rules out CVT) and obtain plantar-flexion lateral radiographs to assess talonavicular reducibility — then refer early for serial manipulation and casting using the Dobbs method, since timely minimally invasive treatment avoids the stiffness, scarring, and long-term arthrosis associated with extensive surgical release.
This 2015 narrative review by Miller and Dobbs covers congenital vertical talus (CVT) — a rare, rigid rocker-bottom flatfoot caused by fixed dorsal dislocation of the navicular on the talus — addressing its epidemiology, genetic and neuromuscular etiology, pathoanatomy, radiographic diagnosis, classification, and the evolution from extensive surgical release toward a minimally invasive casting-based approach.
When you see a rigid rocker-bottom flatfoot in a newborn, confirm hindfoot equinus is present (its absence rules out CVT) and obtain plantar-flexion lateral radiographs to assess talonavicular reducibility — then refer early for serial manipulation and casting using the Dobbs method, since timely minimally invasive treatment avoids the stiffness, scarring, and long-term arthrosis associated with extensive surgical release.