Vertical Talus Vertical talus is a rare deformity of the foot that is diagnosed at birth. Because babies are born with the condition, it is also known as congenital vertical talus. It is one of the causes of a flatfoot in the newborn. One foot, or both feet, may be affected. Although it is not painful for the newborn or even the toddler, if it is left untreated, vertical talus can lead to serious disability and discomfort later in life. Anatomy The talus is a small bone that sits between the heel bone (calcaneus) and the two bones of the lower leg (tibia and fibula). The tibia and fibula sit on top and around the sides of the talus to form the ankle joint. The talus is an important connector between the foot and the leg, helping to transfer weight across the ankle joint. Description In vertical talus, the talus bone has formed in the wrong position, and subsequently, the other bones in the foot are not lined up properly. As a result, the front of the foot points up and may even rest against the front of the shin. The bottom of the foot is stiff and has no arch — in fact, it usually curves out — and is often described as "rocker bottom." This is distinctly different than a clubfoot. Vertical talus is usually diagnosed at birth. Other foot deformities in the newborn are more common, and vertical talus is often initially misdiagnosed as some other type of newborn flatfoot, such as an oblique talus or calcaneovalgus deformity. Some clinicians with less experience in these newborn foot conditions have even incorrectly thought of this as a clubfoot. Cause The exact cause of vertical talus in not known. Many cases, however, however, are associated with a neuromuscular disease or other disorder, such as arthrogryposis, spina bifida, and numerous syndromes. Your doctor may decide to perform additional tests to discover whether your infant has any of these other conditions. Examination Pediatric orthopaedic doctors are able to diagnose vertical talus by simply examining the child. Your doctor may order a special X-ray of your child's foot to confirm the diagnosis. Outcomes Without treatment, you child's vertical talus will most likely result in future pain and disability. With treatment, you can expect a stable and functional foot that should serve your child well throughout their life. If your child has no other conditions that limit function and development, you can expect your child to run and play without pain, and to wear normal shoes. Your child's doctor will likely recommend repeat clinic visits over the years to observe the growth and development of your child's foot.