RARE CONGENITAL DEFORMITIES OF THE FOOT Congenital talipes equinus is occasionally Met with, and differs from the one produced by a congenital spastic contraction of the gas trocnemius muscle (congenital cerebral palsy, Little).
Tenotomy of the tend° Achillis and subsequent plaster-of-Paris bandage for two or three weeks will correct the deformity.
Congenital flat-foot is sometimes found in combination with club foot, but there is a tendency to a pes valgus deformity in a certain per centage of newborn infants. A marked flat-foot deformity, however, is not of frequent occurrence. The do•sum of the foot during the em bryonic stage is pressed against the leg and retained in that position. Postfetal marks are left as evidence of this position. The feet of the newborn persist in this attitude of rest for a long time (Fig. on).
The foot is pronated, dorsi-flexed and abducted at ChoparCs joint. This is the exact counterpart to congenital club-foot. The sole is flat
and in some cases convex, and the contours of the bones of the foot are visible under the skin of the sole.
The shortened peroneal, dorsal, and flexor muscles prevent a correction of this deformity. Correction is much easier than in club-feet and relapses are less liable to result, although a number of cases which make their appearance later in life must be traced back to a congenital disposition.
The treatment consists in applying paste and plaster-of-Paris band ages and braces similar to the treatment of club-feet.
Congenital talipes calcaneus also belongs to this category both as regards treatment and etiology. It is generally combined with a valgus component. and in rare eases the foot is totally dorsi-flcxed. Other deformities of the foot and toes are identical with those of the hands and fingers and need only be mentioned here.