Diagnosis and treatment of pediatric foot deformities.

In children, the lower extremities have extremely wide variations of normal, including calcaneovalgus foot, metatarsus adductus and flatfoot. The first two conditions often resolve or improve spontaneously over time and may be considered abnormal if they persist into adulthood. Serial casting, splints and surgery are rarely necessary. Corrective shoes, orthotic inserts and some forms of splinting have not proved to be effective. The primary care physician must establish an early and correct diagnosis, perform a general screening examination to rule out accompanying musculoskeletal deformities, assess the conditions that may become disabling and require treatment, and reassure parents and family members when observation with close follow-up is the most appropriate course of action.