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ISSN 2007-087X (Print)
Órgano Oficial de la Sociedad Mexicana de Ortopedia Pediátrica

2017, Number 1

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Rev Mex Ortop Ped 2017; 19 (1)

Treatment of congenital vertical talus with Dobbs method: Systematic review of the literature

Masquijo JJ, Eamara AP

Language: Spanish
References: 31
Page: 23-28
PDF size: 157.15 Kb.


ABSTRACT

Background: Congenital vertical talus (CVT) is a rare deformity that occurs at birth and is characterized by fixed dorsal dislocation of the navicular on the head of the talus. The traditional treatment has consisted of the extensive soft tissue release with poor results and a high rate of complications. Recently, a minimally invasive technique (Dobbs method) has been described with encouraging results. We systematically reviewed the literature to: 1) determine the efficacy of the method in patients with isolated and teratological CVT, 2) determine the recurrence rate and complications, and 3) identify risk factors for recurrence of the deformity. Methods: Using databases available from Ovid, PubMed and Cochrane Library, we collected all papers on patients with diagnosis of CVT treated with Dobbs method. Studies published in Spanish, English or German since June 2006 (initial description of the method) were included for the analysis until October 1, 2016. Results: 161 patients (84 teratological, and 77 idiopathic patients) were analyzed. Mean age was 3.8 months (range, two days to nine years). Mean number of casts was 6.8 (range, five to 10). In all cases the initial correction of the deformity was achieved. No patient presented complications related to casting, Achilles tenotomy or talo-navicular realignment through the mini-approach. Mean follow-up was 31.4 months. Thirty-two feet (20%) presented recurrence of the deformity. Patients with teratological CVT had a higher rate of recurrence compared to idiopathic CVT (23% versus 17%). Conclusions: Treatment of congenital vertical talus with Dobbs method is safe and effective. Patients with syndromic or neurological associations have an increased risk of relapse and should be monitored to diagnose this complication early. Initial reports with this technique are encouraging, however long-term studies are needed to confirm if these results are maintained over time.


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