Curso de introducción. Astrágalo vertical congénito: protocolo terapéutico
Palabras clave:
Astrágalo Vertical Congénito, Pie Plano, Etiología, Genética, TerapéuticaResumen
El astrágalo vertical congénito es una deformidad infrecuente del pie que se presenta al nacimiento y que se caracteriza por un pie plano rígido asociado a una luxación irreductible del escafoides sobre el astrágalo, que puede tener grados variables de rigidez. Esta deformidad, de no ser tratada, produce dolor e incapacidad funcional para la marcha. El diagnóstico es clínico y se confirma mediante estudios radiográficos, principalmente dinámicos, que demuestran la irreductibilidad de la luxación de la articulación astrágalo-escafoidea. Por la gran diversidad de factores etiológicos capaces de producir la deformidad, por la rigidez y la complejidad de los cambios morfo-mecánicos, se han diseñado a lo largo de la historia gran cantidad de tratamientos, la mayoría de ellos con resultados reportados como aceptables en series de casos de revisiones retrospectivas con escasa cantidad de pacientes. Se propone un protocolo de tratamiento racional, enfocado a grupos de edad en los cuales la deformidad, asociada a deformación ósea adaptativa, se estructura progresivamente y que puede proporcionar resultados más favorables a largo plazo, cuando están indicadas las cirugías extensas.
Descargas
Citas
1. McKie J, Radomisli T. Congenital vertical talus: a review. Clin Podiatr Med Surg 2010; 27(1): 145-56.
2. Adelaar RS, Williams RM, Gould JS. Congenital convex pes valgus: results of an early comprehensive release and a review of congenital vertical talus at Richmond Crippled Children's Hospital and the University of Alabama in Birmingham. Foot Ankle 1980; 1(2): 62-73.
3. Da Paz AC Jr, de Souza V, de Souza DC. Congenital convex pes valgus. Orthop Clin North Am 1978; 9: 207-18.
4. DeRosa GP, Ahlfeld SK. Congenital vertical talus: the Riley experience. Foot Ankle 1984; 5(3): 118-24.
5. Dodge LD, Ashley RK, Gilbert RJ. Treatment of the congenital vertical talus: a retrospective review of 36 feet with long-term follow-up. Foot Ankle 1987; 7(6): 326-32.
6. Drennan J. Congenital vertical talus. J Bone Joint Surg Am 1995; 77:1916-23.
7. Oppenheim W, Smith C, Christie W. Congenital vertical talus. Foot Ankle 1985; 5(4): 198-204.
8. Aroojis AJ, King MM, Donohoe M, Riddle EC, Kumar SJ. Congenital vertical talus in arthrogryposis and other contractural syndromes. Clin Orthop Relat Res 2005; (434): 26-32.
9. Clark MW, D’Ambrosia RD, Ferguson AB. Congenital vertical talus: treatment by open reduction and navicular excision. J Bone Joint Surg Am 1977; 59(6): 816-24.
10. Jackson D. Acquired vertical talus due to burn contractures report of two cases. J Bone Joint Surg Br 1978; 60-B(2): 215-8.
11. Duncan RD, Fixsen JA. Congenital convex pes valgus. J Bone Joint Surg Br 1999; 81(2): 250-4.
12. Eyre-Brook AL. Congenital vertical talus. J Bone Joint Surg Br 1967; 49(4): 618-27.
13. Griffin DW, Daly N, Karlin JM. Clinical presentation of congenital convex pes valgus. J Foot Ankle Surg 1995; 34(2): 146-52.
14. Jacobsen ST, Crawford AH. Congenital vertical talus. J Pediatr Orthop 1983; 3(3): 306-10.
15. Lloyd-Roberts GC, Spence AJ. Congenital vertical talus. J Bone Joint Surg Br 1958; 40-B(1): 33-41.
16. Drennan JC, Sharrard WJW. The pathological anatomy of convex pes valgus. J Bone Joint Surg 1971; 53-B(3): 455-61.
17. Fitton JM, Nevelös AB. The treatment of congenital vertical talus. J Bone Joint Surg Br 1979; 61-B(4): 481-3.
18. Storen H. Congenital convex pes valgus with vertical talus. Acta Orthop Scand 1967; Suppl 94: 1-104.
19. Storen H. On the closed and open correction of congenital convex pes valgus with a vertical astragalus. Acta Orthop Scand 1965; 36(3):352-8.
20. Sullivan JA. Pediatric flatfoot: evaluation and management. J Am Acad Orthop Surg 1999; 7(1): 44-53.
21. Alaee F, Boehm S, Dobbs MB. A new approach to the treatment of congenital vertical talus. J Child Orthop 2007; 1(3): 165-74.
22. Bhaskar A. Congenital vertical talus: treatment by reverse Ponseti technique. Indian J Orthop 2008; 42(3): 347-50.
23. Bhaskar A. Congenital vertical talus: treatment by reverse Ponseti technique. Indian J Orthop 2008; 42(3): 347-50.
24. Dobbs MB, Purcell DB, Nunley R, Morcuende JA. Early results of a new method of treatment for idiopathic congenital vertical talus. J Bone Joint Surg Am 2006; 88(6): 1192-200.
25. Dobbs MB, Purcell DB, Nunley R, Morcuende JA. Early results of a new method of treatment for idiopathic congenital vertical talus. Surgical technique. J Bone Joint Surg Am 2007; 89 Suppl 2 Pt.1: 111-21.
26. Coleman SS, Stelling FH 3rd, Jarrett J. Pathomechanics and treatment of congenital vertical talus. Clin Orthop Relat Res 1970; 70: 62-72.
27. Mazzocca AD, Thomson JD, Deluca PA, Romness MJ. Comparison of the posterior approach versus the dorsal approach in the treatment of congenital vertical talus. J Pediatr Orthop 2001; 21(2): 212-7.
28. Walker AP, Ghali NN, Silk FF. Congenital vertical talus. The results of staged operative reduction. J Bone Joint Surg Br 1985; 67(1): 117-21.
29. Seimon LP. Surgical correction of congenital vertical talus under the age of 2 years. J Pediatr Orthop 1987; 7(4): 405-11.
30. Stricker SJ, Rosen E. Early one-stage reconstruction of congenital vertical talus. Foot Ankle Int 1997; 18(9): 535-43.
31. Saini R, Gill SS, Dhillon MS, Goyal T, Wardak E, Prasad P. Results of dorsal approach in surgical correction of congenital vertical talus: an Indian experience. J Pediatr Orthop B 2009; 18(2): 63-8.
32. Lamy L, Weissman L. Congenital convex pes planus. J Bone Joint Surg 1939; 21: 79-91.
33. Osmond-Clarke H. Congenital vertical talus. J Bone Joint Surg Br 1956; 38-B(1): 334-41.
34. Herndon CH, Heyman CH. Problems in the recognition and treatment of congenital pes valgus. J Bone Joint Surg Am 1963; 45: 413-29.
35. Ogata K, Schoenecker PL, Sheridan J. Congenital vertical talus and its familial occurrence: an analysis of 36 patients. Clin Orthop Relat Res 1979; (139): 128-32.
36. Kodros SA, Dias LS. Single-stage surgical correction of congenital vertical talus. J Pediatr Orthop 1999; 19(1): 42-8.
37. Mantilla J, Ochoa G. Astrágalo vertical congénito. Protocolo terapéutico. Monografía. Hospital Infantil Universitario de San José. Servicio de Ortopedia Infantil. Bogotá: Universidad El Bosque; 2010.
38. Colton CL. The surgical management of congenital vertical talus. J Bone Joint Surg Br 1973; 55(3): 566-74.
39. Ester AR. Altered transmission of HOX and apoptotic SNPs identify a potential common pathway for clubfoot. Am J Med Genet A 2009;149A: 2745-52.
40. Bosker BH, Goosen JH, Castelein RM, Mostert AK. Congenital convex pes valgus (congenital vertical talus). The condition and its treatment: a review of the literature. Acta Orthop Belg 2007; 73(3):366-72.
41. Duckworth T, Smith TWD. The treatment of paralytic convex pesvalgus. J Bone Joint Surg 1974; 56-B(2): 305-13.
42. Jacobsen ST, Crawford AH. Congenital vertical talus. J Pediatr Orthop 1983; 3(3): 306-10.
43. Greenberg AJ. Congenital vertical talus and congenital calcaneovalgus deformity: a comparison. J Foot Surg 1981; 20(4): 189-93.
44. Harrold AJ. Congenital vertical talus in infancy. J Bone Joint Surg Br 1967; 49(4): 634-43.
45. Harrold AJ. The problem of congenital vertical talus. Clin Orthop Relat Res 1973; (97): 133-43.
46. Jacobs M. Congenital vertical talus. Tex Med 1963; 59: 864-7.
47. Hamanishi C. Congenital vertical talus: classification with 69 cases and new measurement system. J Pediatr Orthop 1984; 4(3): 318-26.
48. Lichtblau S. Congenital vertical talus. Bull Hosp Joint Dis 1978; 39(2):165-79.
49. Napiontek M. Congenital vertical talus: a retrospective and critical review of 32 feet operated on by peritalar reduction. J Pediatr Orthop B 1995; 4(2): 179-87.
50. Robbins H. Naviculectomy for congenital vertical talus. Bull Hosp Joint Dis 1976; 37(2): 77-97.
51. Dobbs MB, Gurnett CA, Pierce B, Exner GU, Robarge J, Morcuende JA, Cole WG, Templeton PA, Foster B, Bowcock AM. HOXD10 M319K mutation in a family with isolated congenital vertical talus. J Orthop Res 2006; 24(3): 448-53.
52. Dobbs MB, Gurnett CA, Robarge J, Gordon JE, Morcuende JA, Bowcock AM. Variable hand and foot abnormalities in family with congenital vertical talus and CDMP-1 gene mutation. J Orthop Res 2005; 23(6): 1490-4.
53. Dobbs MB, Schoenecker PL, Gordon JE. Autosomal dominant transmission of isolated congenital vertical talus. Iowa Orthop J 2002; 22: 25-7.
54. Gurnett CA, Keppel C, Bick J, Bowcock AM, Dobbs MB. Absence of HOXD10 mutations in idiopathic clubfoot and sporadic vertical talus. Clin Orthop Relat Res 2007; 462: 27-31.
55. Levinsohn EM, Shrimpton AE, Cady RB, Packard DS, Hootnick DR. Congenital vertical talus in four generations of the same family. Skeletal Radiol 2004; 33(11): 649-54.
56. Marcinko DE, Azzolini TJ, Mariash SA. Enigma of pediatric vertical talus deformity. J Foot Surg 1990; 29(5): 452-8.
57. Merrill BS. Skeletal muscle abnormalities and genetic factors related to vertical talus. Clin Orthop Relat Res 2011; 469(4): 1167-74.
58. Schwering L. Surgical correction of the true vertical talus deformity. Oper Orthop Traumatol 2005; 17(2): 211-31.
59. Searfoss R. Vertical talus of unusual etiology. Case report. J Bone Joint Surg Am 1975; 57: 409-11.
60. Shrimpton. A HOX gene mutation in a family with isolated congenital vertical talus and Charcot-Marie-Tooth disease. Am J Hum Genet 2004; 75: 92-6.
61. Stern HJ, Clark RD, Stroberg AJ, Shohat M. Autosomal dominant transmission of isolated congenital vertical talus. Clin Genet 1989;36(6): 427-30.
62. Julia S, Pedespan JM, Boudard P, Barbier R, Gavilan-Cellie I, Chateil JF, Lacombe D. Association of external auditory canal atresia, vertical talus, and hypertelorism: confirmation of Rasmussen syndrome. Am J Med Genet 2002; 110(2): 179-81.
63. Specht EE. Congenital paralytic vertical talus. An anatomical study. J Bone Joint Surg Am 1975; 57(6): 842-7.
64. Høiness PR. Grice arthrodesis in the treatment of valgus feet in children with myelomeningocele: a 12.8-year follow-up study. J Child Orthop 2009; 3: 283-90.
65. Thometz MRI. Pathoanatomy study of congenital vertical talus. J Pediatr Orthop 2010; 30: 460-4.
66. Drennan JC. Congenital vertical talus. Instr Course Lect 1996; 45: 3 15-22.
67. Ochoa G. Pie equino varo congénito idiopático (segunda parte). Rev Col Or Tra 1996; 10(2): 112-38.
68. Reimann IM. Pathology of congenital metatarsus varus and its relationship to other congenital deformities of the foot. Orthop Clin North Am 1978; 9(1): 219-24.
69. Outland T, Sherk HH. Congenital vertical talus. Clin Orthop 1960 ;16: 214-8.
70. Klein DM, Merola AA, Spero CR. Congenital vertical talus with a talocalcaneal coalition. J Bone Joint Surg Br 1996; 78(2): 326-7.
71. Zorer G, Bagatur AE, Dogan A. Single stage surgical correction of congenital vertical talus by complete subtalar release and peritalar reduction by using the Cincinnati incision. J Pediatr Orthop B 2002;11(1): 60-7.
72. Grice DS. An extra-articular arthrodesis of the subastragalar joint for the correction of paralitic flat feet in children. J Bone Joint Surg Am 1952; 34: 927-56.
73. Grice DS. Further experience with extra-articular arthrodesis of the subtalar joint. J Bone Joint Surg Am 1955; 37: 246-365.
74. McCall RE, Lillich JS, Harris JR, Johnston FA. The Grice extraarticular subtalar arthrodesis: a clinical review. J Pediatr Orthop 1985; 5(4):442-5.
75. Evans D. Relapsed club foot. J Bone Joint Surg 1961; 43B(4): 722-33.
76. Evans D. Calcaneovalgus deformity. J Bone and Joint Surg 1975; 57B:270.
77. Masterson E, Borton D, Stephens MM. Peroneus longus tendon sling in revision surgery for congenital vertical talus: a new surgical technique. Foot Ankle 1993; 14(4): 186-8.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2025 Sociedad Colombiana de Cirugía Ortopédica y Traumatología.

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
| Estadísticas de artículo | |
|---|---|
| Vistas de resúmenes | |
| Vistas de PDF | |
| Descargas de PDF | |
| Vistas de HTML | |
| Otras vistas | |








