The Newborn Foot -- American Family Physician

regions (Figure 1): the hindfoot or rearfoot (talus and calcaneus); the midfoot (navicular bone, cuboid bone, and three cuneiform bones); and the forefoot (metatarsals and phalanges). Differences between a newborn foot and an adult foot are summarized in Table 1. Simultaneous observation of both feet can reveal many deformities. The skin should be examined for unusual creases or folds that can be formed by various foot deviations. Certain areas of the skin might be abnormally taut, indicating extra tension on the skin, while the skin on the opposite side of the foot might reveal loose, excessive skinfolds. During the next part of the examination, various foot and ankle joints are moved through their respective ranges of motion. The joints should be assessed for flexibility or rigidity, unusual positions, lack of motion, and asymmetry. Finally, the vascular examination consists of assessment of capillary refill and skin color, because pulses are difficult to palpate. Fortunately, the majority of newborns exhibit excellent lower extremity vascular supply, unless it is compromised by an extrinsic factor, such as an intrauterine amniotic band. T he examination of the feet is an essential component of a comprehensive evaluation of a newborn. With proper skills, this examination, which often is reassuring to new parents, can be performed quickly, yet thoroughly. Early detection of foot problems in infants allows timely corrective treatment, if required.