Foot and Ankle: Paediatric Measurements
This is a difficult, complex and often confusing topic to the uninitiated for a variety of reasons. These range from a lack of knowledge of the congenital and neuromuscular disorders associated with foot deformities, inexperience in analysing paediatric foot radiographs and lack of understanding of the descriptive terms used to document the abnormalities. Most of the measurements are based on the dorsoplantar (AP) and lateral radiographic views. Importantly the views are frequently obtained on weight bearing or simulated weight bearing (in infants or non-ambulatory patients, weight bearing can be simulated by dorsiflexion stress). The function of the foot is to transmit load, adapt to varying surface conditions and act as a lever for progression with effects at the knee and the hip. Adaptation requires flexibility, and only during weight bearing or simulated weight bearing will the configuration of the bony skeleton allowed by the constraints of the ligamentous structures become apparent.
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