Knee, lower leg, foot, and ankle disorders in children

The literature of the past year increased our understanding of the etiology of some common lower leg disorders in children, and increased our knowledge about the results and complications of some old and new treatment methods. Histochemical and vascular studies and magnetic resonance imaging were used to study the etiology and treatment of congenital clubfoot. Results of early intervention protocols and the ilizarov method were reported. Undercorrection at primary surgery was identified as a major reason for reoperation. Excision of the coalition with interposition of fat or tendon produced good results in selected children with middle facet talocalcaneal coalition. A footprint-measuring system can differentiate among a normal foot, a flexible flatfoot, and a rigid flatfoot. Classification of metatarsus adductus was questioned, and polydacytyly of the foot was classified in detail. The treatment of leg length discrepancy and angular deformities by osteotomy, hemiepiphysiodesis, and external fixation techniques was described. Several treatments were reported for congenital pseudarthrosis of the tibia. In all, the reports of the past year offer hope for improving the results of treatment by better understanding, innovative surgical techniques, and better methods to determine timing of surgery and predicting results.