The foot in Apert syndrome

Foot deformity in Apert syndrome is very characteristic and predictable. Progressive synostosis occurs on what is presumably an unsegmented cartilaginous mass. The first ray shortens with medial deviation of the great toe, secondary to growth abnormality and a delta phalanx. The two phalanx digits characteristically go on to fusion, with maintenance of minimal motion at the metatarsal phalangeal joints. The midfoot and hindfoot progress to characteristic fusion in a supinated position. There is prominence of the fifth metatarsal with callosities under the fifth and third metatarsal heads in all patients. Orthotic and surgical management of these conditions is necessary to ensure maximal function in the symptomatic Apert patient.