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UNASSIGNED: There is evidence that the use of WEIGHTBEARING imaging aids in the assessment of progressive collapsing foot deformity (PCFD). The following WEIGHTBEARING conventional radiographs (CRs) are necessary in the assessment of PCFD patients: anteroposterior (AP) foot, AP or mortise ankle, and lateral foot. If available, a hindfoot alignment view is strongly recommended. If available, WEIGHTBEARING computed tomography (CT) is strongly recommended for surgical planning. When WEIGHTBEARING CT is obtained, important findings to be assessed are sinus tarsi impingement, subfibular impingement, increased valgus inclination of the posterior facet of the subtalar joint, and subluxation of the subtalar joint at the posterior and/or middle facet.
UNASSIGNED: Level V, consensus, expert opinion.

UNASSIGNED: There is evidence that the medial displacement calcaneal osteotomy (MDCO) can be effective in treating the progressive collapsing foot deformity (PCFD). This juxta-articular osteotomy of the tuberosity shifts the mechanical axis of the calcaneus from a more lateral position to a more medial position, which provides mechanical advantage in the reconstruction for this condition. This also shifts the action of the Achilles tendon medially, which minimizes the everting deforming effect and improves the inversion forces. When isolated hindfoot valgus exists with adequate talonavicular joint coverage (less than 35%-40% uncoverage) and a lack of significant forefoot supination, varus, or abduction, we recommend performing this osteotomy as an isolated bony procedure, with or without additional soft tissue procedures. The clinical goal of the hindfoot valgus correction is to achieve a clinically neutral heel, as defined by a vertical axis from the heel up the longitudinal axis of the Achilles tendon and distal aspect of the leg. The typical range when performing a MDCO, while considering the location and rotation of the osteotomy, is 7 to 15 mm of correction.
UNASSIGNED: Level V, consensus, expert opinion.

Intrinsic plus foot deformity has primarily been associated with cerebral palsy and involves spastic contracture of the intrinsic musculature with resultant toe deformities. Digital deformity is caused by a dynamic imbalance between the intrinsic muscles in the foot and extrinsic muscles in the lower leg. Spastic contracture of the toes frequently involves curling under of the lesser digits or contracture of the hallux into valgus or plantarflexion deformity. Patients often present with associated pressure ulcers, deformed toenails, shoe or brace fitting challenges, and pain with ambulation or transfers. Four different patterns of intrinsic plus foot deformity have been observed by the authors that likely relate to the different patterns of muscle involvement. Case examples are provided of the 4 patterns of intrinsic plus foot deformity observed, including global intrinsic plus lesser toe deformity, isolated intrinsic plus lesser toe deformity, intrinsic plus hallux valgus deformity, and intrinsic plus hallux flexus deformity. These case examples are presented to demonstrate each type of deformity and our approach for surgical management according to the contracture pattern. The surgical approach has typically involved tenotomy, capsulotomy, or isolated joint fusion. The main goals of surgical treatment are to relieve pain and reduce pressure points through digital realignment in an effort to decrease the risk of pressure sores and allow more effective bracing to ultimately improve the patient\'s mobility.

BACKGROUND: There is a paucity of evidence regarding the design of children\'s footwear in relation to musculoskeletal structure.
OBJECTIVE: The aim was to gain consensus regarding where flexibility and support should be given on a school shoe for the 6- to 10-year-olds.
METHODS: Delphi Questionnaire.
METHODS: Recruitment of 10 Allied Health Professionals yielded a consensus group. Those recruited had dedicated experience in paediatrics and foot health. Rounds of questions were delivered to investigate the basis of the opinions made by the group on the location of support and flexibility in a school shoe for the age range identified.
RESULTS: Six themes were generated. Four themes gained 100% consensus regarding footwear allowing normal foot movement, footwear allowing normal forefoot function, footwear providing a stable base and the foot being secure in the shoe. Fleiss\' kappa calculations revealed \'poor agreement\' for the remaining two themes regarding clinical intervention and the purpose of footwear design in the midfoot in both the upper and sole of the shoe.
CONCLUSIONS: The qualitative data generated through discussion have highlighted areas where more understanding and research are required, particularly in understanding how, in the long term, shoe design can affect the developing foot.
CONCLUSIONS: Children\'s footwear advice is often delivered from experience and personal belief. This article questions current understanding and opinion from clinical experts in the field of paediatric footwear and highlights that there is a lack of knowledge and confidence into the effects of children\'s footwear. There is a strong requirement for further empirical research to be completed on children\'s footwear to allow clinicians to formulate relevant and appropriate footwear advice.

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