Epidemiology
Presents in late childhood
Often unilateral
More often right side
NHx
Tends to increase with age
- rarely a problem until late childhood
- associated with PF instability & pain
Aetiology
Spina bifida / CP
Torsional Malalignment Syndrome
Miserable Malalignment Syndrome
- IFT with compensatory ETT
Management
Non-operative Management
Useless
- rarely indicated on functional grounds
- lever action of foot is not lost until the FPA > 60°
Operative Management
Indications
- osteotomy indicated if TFA > 40°
- certain cases of CTEV & NMD