Inspection Of The Feet In Prone Position
Procedure
- The child lies in prone position with stretched hips and knees.
- Examine one leg first and then the other.
- Bring the knee into 90° flexion.
- Inspect the plantar side of the foot.
- The medial edge of the foot should form a straight line.
- If the forefoot makes a medially-inclined angle with respect to the rear foot, it may indicate metatarsus adductus (only adduction of the forefoot) or metatarsus varus (an inversion component is present as well as adduction of the forefoot).
- Stabilise the foot if necessary by placing at most one finger on the sole of the child’s foot.
- Determine the angle that the foot (reference line is a line through the third shaft) makes with a straight line (running in a proximal to distal direction) through the middle of the upper leg.
- Normally, the foot is at 0-20° with respect to the line through the upper leg and should point laterally (except in the case of neonates where the foot will point slightly more medially).
- If the foot is pointing more than 5° medially, the child will be pigeon-toed.