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Once a year: check-up – until skeletal maturity c) treatment started around the age of 4 The treatment of these children may differ a lot from the normal management for smaller children. To achieve to some extent a satisfactory correction of the feet, the child may require a transfer of the tibialis anterior tendon or other surgery as well. The treatment and check-up plan needs to be individually planned. 3. Check more often, if… - …you doubt that the parents follow the bracing schedule. g. pressure sores).

Put the thumb over the lateral aspect of the head of the Talus. 2. Put the index finger of the same hand over the posterior aspect of the lateral Malleolus. 3. Abduct the forefoot with the other hand while holding counter-pressure on the lateral aspect of the head of the Talus and posterior aspect of the lateral Malleolus. 4. Never abduct the foot beyond 40° (only about 30° is good). If you gain for more abduction, it is likely to produce a deformity with even more flexed Metatarsals and toes and hyper abduction of the Metatarsals in the Lisfranc joint line.

8. First toe is short and hyper-extended. 9. Calf muscles small and bunched-up in the upper third of the calf. 10. Achilles tendon is very wide, long, and tight up to the middle third of the calf. 2. Precise Identification of the head of the Talus and the Talo-calcaneo-navicular joint In these cases, it is very important to localize the head of the Talus very well. The head of the Talus is difficult to locate, because it is less prominent than the anterior tuberosity of the Calcaneus. The motion in the Talocalcaneo-navicular joint is first minimal, but should be felt more after the 2nd or 3rd plaster cast.

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