title: Primary outcomes of the congenital vertical talus correction using the Dobbs method of serial casting and limited surgery.
abstract: BACKGROUND
  The traditional treatment for congenital vertical talus, which involves serial casting and extensive soft-tissue releases, has been associated with severe stiffness and other complications in adolescents and adults. Our hypothesis is that favorable results will be obtained using the Dobbs method of serial manipulation, casting, and limited surgery for vertical talus correction, even in older children and syndromic cases. Therefore, the present study aimed at evaluating the Dobbs method in such cases.
  
  
  METHODS
  We treated 15 feet of 10 patients (aged from 1 month to 9 years) using manipulation and serial casting or the reverse Ponseti method followed by percutaneous Achilles tenotomy and limited open reduction of the talonavicular joint. All patients were evaluated both clinically and radiologically in a mean follow-up period of 2 years.
  
  
  RESULTS
  After 2 years, all patients had plantigrade and flexible feet with good radiographic correction. The mean talocalcaneal angle before (70.5° ± 10.5) and after (31° ± 5.2) treatment and the talar axis metatarsal base angle before (60° ± 11.4) and after (15° ± 6.7) treatment were significantly improved (P < 0.001).
  
  
  CONCLUSIONS
  Recent research has shown that manipulation and serial casting followed by limited surgery (Dobbs method) was successful in treating idiopathic congenital vertical talus. Our results also showed that this method resulted in an excellent outcome in both idiopathic and syndromic congenital vertical talus, even in older children.
authors.affiliation: Department of Orthopedics, Shohada Hospital, Tabriz University of Medical Science, Tabriz, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Aslani
authors.forename: Ali
authors.initials: A
authors.lastname: Sadigi
authors.forename: Ali
authors.initials: A
authors.lastname: Tabrizi
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Bazavar
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mousavi
keywords: Casting; Congenital vertical talus; Conservative treatment
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