skew foot

S-shaped foot, serpentine foot, skewfoot deformity, Z foot deformity, zed foot Orthopedics A foot deformity consists of marked metatarsus adductus of forefoot and plantarflexion, hindfoot valgus, and lateral displacement of midfoot in abduction with lateral displacement of navicular on talar head, prominence of the talar head in medial arch with possible flattening of medial arch and presence of thickened callus over the head of the plantarflexed talus, tendoachilles contracture of variable degree, and deformity may be rigid or supple Imaging Lateral displacement of navicular on head of talus, metatarsal adduction; in the normal foot on AP radiograph, a line drawn through long axis of first metatarsal and a line drawn through long axis of talus should be parallel or divergent laterally, widening of the talocalcaneal angle on AP radiograph usually greater than 35º, and increased lateral talocalcaneal angle with plantarflexion of talus Management-nonoperative Serial casting is mainstay of nonoperative care, similar to that for metatarsus adductus but heel is held in neutral to slight varus, successful nonoperative treatment improves appearance of foot and reasonably corrects radiographic features; cast treatment for SD is longer than that needed for metatarsus adductus; serial casting of ± 8–10 wks and static casting of 2–4 wks is usual Operative management Usually not indicated until early childhood

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