DPM Pediatric Podiatry 1 — Questions and Answers
Question 1: What is the most common congenital foot deformity present at birth?
- Talipes equinovarus (clubfoot) (Correct answer)
- Metatarsus adductus
- Congenital flatfoot
- Cavus foot
Correct answer: Talipes equinovarus (clubfoot)
Talipes equinovarus (clubfoot) is the most common congenital foot deformity, occurring in approximately 1-2 per 1,000 live births.
Question 2: Which treatment method is considered the gold standard first-line approach for congenital talipes equinovarus (clubfoot)?
- Early surgical correction
- Ponseti casting method (Correct answer)
- Denis Browne splinting alone
- Passive stretching only
Correct answer: Ponseti casting method
The Ponseti method—a series of weekly manipulations and casts followed by bracing—is the gold standard for clubfoot treatment, achieving correction in over 95% of cases.
Question 3: Metatarsus adductus is best described as:
- Lateral deviation of the forefoot relative to the hindfoot
- Medial deviation of the forefoot relative to the hindfoot (Correct answer)
- Plantarflexion of the entire foot
- Dorsiflexion deformity of all toes
Correct answer: Medial deviation of the forefoot relative to the hindfoot
Metatarsus adductus involves medial (inward) deviation of the forefoot relative to the hindfoot, giving the foot a C-shaped or kidney-bean appearance.
Question 4: Which classification system is most commonly used to grade the severity of metatarsus adductus?
- Salter-Harris classification
- Bleck classification (Correct answer)
- Lauge-Hansen classification
- Weber classification
Correct answer: Bleck classification
The Bleck classification grades metatarsus adductus by assessing the heel bisector line relative to the toes to determine mild, moderate, or severe deformity.
Question 5: Calcaneovalgus foot deformity in newborns is characterized by:
- Inversion and plantarflexion of the foot
- Dorsiflexion and eversion of the foot (Correct answer)
- Supination and adduction of the forefoot
- Equinus position with heel varus
Correct answer: Dorsiflexion and eversion of the foot
Calcaneovalgus presents as dorsiflexion and eversion of the foot, often with the dorsum resting against the anterior tibia; it typically resolves spontaneously with gentle stretching.
Question 6: The most common cause of in-toeing gait in children aged 3–10 years is:
- Metatarsus adductus
- Internal tibial torsion
- Femoral anteversion (Correct answer)
- Clubfoot residual
Correct answer: Femoral anteversion
Femoral anteversion—where the femoral neck is excessively rotated anteriorly—is the most common cause of in-toeing in children ages 3–10 and typically resolves spontaneously by adolescence.
Question 7: At what age does the medial longitudinal arch typically complete its development in children?
- By 18 months
- By 3 years
- By 6–8 years (Correct answer)
- Not until puberty
Correct answer: By 6–8 years
The medial longitudinal arch typically develops by 6–8 years of age as the foot musculature and ligaments mature; flatfoot before this age is generally considered physiologic.
DPM Pediatric Podiatry 1
What is the most common congenital foot deformity present at birth?