Australian Doctor 19th April issue | Page 42

42 HOW TO TREAT : PAEDIATRIC FOOT AND ANKLE DEFORMITY

42 HOW TO TREAT : PAEDIATRIC FOOT AND ANKLE DEFORMITY

19 APRIL 2024 ausdoc . com . au
A
Alaee F , et al . A new approach to the treatment of congenital vertical talus . Journal of Children ’ s Orthopaedics 2007 ; 1:165-174 / CC
BY 4.0 / bit . ly / 3RMuSn0
Figure 7 . Degree of hip rotation .
Figure 6 . X-rays of an oblique talus .
B
A .
B .
Lateral X-ray of a seven-week-old male with an oblique talus , demonstrating vertical position of the talus .
Lateral plantar flexion X-ray , demonstrating restoration of the normal relationship between the longitudinal axis of the talus and the first metatarsal .
Figure 8 . External rotation to the left .
that most will correct spontane-
see figure 9 ) and transmalleolar
considered internal tibial torsion . The
ously and not require any formal
axis .
transmalleolar axis is a line parallel to
treatment .
A TFA is measured between the
the axis between the medial and lateral
Examining for tibial torsion is
line bisecting the posterior thigh and
malleolus of the ankle and its bisector
also best performed with the child
another line bisecting the foot along
with the axis of the thigh ( see figure
prone on the examination table .
the axis of the second ray . Normally ,
10 ). Normal values are 15-30 ° external .
Figure 9 . Left foot : heel bisector . Right foot : thigh – foot angle .
Once again , thighs flat and knees bent to 90 °. Two measures can be taken : the thigh – foot angle ( TFA ,
the angle is between 0 ° and 30 °. A TFA greater than 30 ° is excessive external tibial torsion , and a TFA less than 0 ° is
Foot
Metatarsus adductus and