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Foot deformities in the newborn--incidence and prognosis
1Karolinska Institute, Department of Orthopedics, Huddinge, Sweden.
Insights
Most newborn foot deformities, like adduction deformity and pes calcaneovalgus, resolve naturally by age six. This study found no treatment is needed for forefoot adductus or calcaneovalgus deformities.
Area of Science:
- Pediatrics
- Orthopedics
- Developmental Biology
Background:
- Foot deformities are common in newborns, with varying degrees of severity and prognosis.
- Early identification and follow-up are crucial for understanding the natural history of congenital foot conditions.
Purpose of the Study:
- To evaluate the long-term outcomes of congenital foot deformities in infants.
- To determine the necessity of orthopedic intervention for specific pediatric foot conditions.
Main Methods:
- Prospective screening of 2,401 newborns for foot deformities.
- Follow-up examinations of affected children between 5-6 years of age.
- Comparison of children with foot deformities against a control group of normal infants.
Main Results:
- A 4.2% incidence of foot deformity was observed at birth.
- Of infants with adduction deformity at birth, 87% had normal feet by reexamination.
- All infants diagnosed with pes calcaneovalgus at birth showed normal foot development by follow-up.
Conclusions:
- Congenital pes calcaneovalgus and forefoot adductus deformities typically resolve without intervention.
- Observation is recommended for these specific pediatric foot conditions, avoiding unnecessary orthopedic referrals.
- Sleeping position (prone) showed no correlation with the persistence of adduction deformity.
Abstract:
In a consecutive screening of 2,401 newborn, a foot deformity was noted in 100 of the infants (4.2 percent). At follow-up 5-6 years later, the children with a foot deformity were reexamined and compared with normal controls. Seventy-six infants had some adduction deformity of the foot at birth. At reexamination, 87 percent of the examined children had normal feet. No association was observed between sleeping prone and the presence of adduction deformity at the reexamination. Pes calcaneovalgus was diagnosed in 18 newborn. Of those reexamined, all had normal feet. Up to the age of 6 years, 4.3 percent of the 2,401 had been referred to the department of orthopedics because of a foot deformity; 50 because of an adduction deformity, and in 10 of these children the deformity was observed at birth. The investigation indicates that no treatment is required for pes calcaneovalgus or adductus deformity confined to the forefoot.