Corrective bandages and daily manipulations for treatment of congenital vertical talus: a thirteenyear follow-up

Purpose To analyze the results of a conservative method for treating congenital vertical talus in children with early start and to know in which cases surgical treatment was needed. Methods A retrospective analysis of all children diagnosed with idiopathic vertical talus was carried out during the years 2008–2021. Thirty-two children (46 feet) were fnally included. Children were treated with serial manipulations, muscle stimulation, and corrective bandages. Age at the time of initiation of treatment, duration of treatment, and correction or not of the deformity without surgical intervention were recorded as variables of interest. The talocalcaneal angle, TAMBA, and ankle range of motion were measured before treatment, after treatment, and at the end of the follow-up period. Statistics decision tree was used to determine which variable best discriminated whether the patient needed surgery. To complement the tree diagram, a two-step cluster analysis was carried out. Results After treatment, TAMBA and talocalcaneal angle changed from "vertical" to "oblique" category in 45 and 37 feet, respectively. The pathological dorsal fexion of the ankle changed to normal in 37 feet and ankle plantar fexion was normal in 46 feet. These variables showed signifcant changes between the three measurement moments. The results of the statistics decision tree and cluster analysis indicate that "No surgery" was associated with an age equal to or lower than one week when treatment was started, and with an ankle plantar fexion range of motion lower than 36°. Conclusions The beginning of this conservative treatment in the frst week of life and having a plantar fexion of the ankle lower than 36° were related to the success of the treatment without surgery.