Condition	Major features	Treatment approach
Metatarsus adductus	C-shaped lateral foot border	Mild: observation
	Prominent styloid process of fifth metatarsal	Moderate: stretching exercises
	Splay between the great and second toes	Severe: casting, bracing
	“V”-finger test deviation of lateral foot border
Clubfoot (talipes equinovarus)	“Down and in” foot appearance	Extrinsic (supple): serial castings, followed by maintenance splinting
	Small atrophic heel, rotated internally	Intrinsic (rigid): initial casting, usually followed by surgical correction
	Concave medial foot border, convex lateral
	Deep medial skin furrow
	Radiographs show parallel axes of talus and calcaneus
Calcaneovalgus	“Up and out” foot appearance	Mild: stretching exercises
	Foot in extreme dorsiflexion (hyperextension)	Moderate: splinting and high-top, rigid-sole, lace-up shoes
	Externally rotated heel	Severe: serial castings, followed by nightly splinting or bivalved casting
	Dorsal forefoot can be touching outer leg
Congenital vertical talus (rocker-bottom foot)	Rigid foot appearance with “reversed” arch	Initial conservative therapy to stretch soft tissues, followed by surgical correction
	Plantarflexed ankle joint with upwardly extended midfoot and forefoot
	Need lateral foot radiograph to confirm
Polydactyly (supernumerary digits)	Usually involves border toes, most commonly the fifth	Surgical: ligation suture (less complex); removal of duplicated structures (more complex)
	Could present as partial (i.e., two nail plates) or complete digit duplication
	No radiographs needed unless surgery is being contemplated
Syndactyly (webbed toes)	Most commonly affects second and third toes	Problem is more cosmetic, rarely requires treatment
	Various levels of webbing, from partial to complete	If surgery is desired, it should be postponed until child is old enough to take part in the decision
Overlapping toes	Usually fifth toe over fourth toe	Stretching, use of silicone toe spacers, taping
	Frequently bilateral	Surgical correction in older children, if symptomatic
	Adduction and external rotation of the little toe, dorsiflexed digit
	Smaller nail plate
Amniotic (annular) bands	Constriction bands over various parts of extremity	Simple bands are cosmetic problems and do not require treatment
	Can lead to vascular compromise, lymphedema	Complex bands require surgical release, especially if neurovascular compromise is present
	Deeper bands can produce complete amputations