19. Foot and toe disorders in children

A ‘foot problem’ in a child is an important reason for an orthopaedic consultation. It is important to realise that the foot problem can be a local abnormality as an expression of a larger and more extensive problem. That is why it is of the utmost importance to start with a general physical examination, with emphasis on the hips and spine. Obtaining an exploratory impression of the neurological status is also a standard part of this examination. Any underlying suffering (e.g. spina bifida, Duchenne’s disease, hereditary motor and sensory neuropathy (HMSN), spinal tumours) has a greater impact than the foot problem itself.