Weakness and other disturbances of the feet are found in more than 50 per cent of all small children.1 Many of these disturbances disappear spontaneously as the child develops better balance and skill in walking. But a small number, about 0.5 per cent, will show persisting ligamentous relaxation of the feet with displacement of the medial tarsal bones inward and downward on weight bearing. Without adequate treatment these feet, showing extreme relaxation, progress to much functional disturbance in adult life. At birth the deformity of the feet in this group varies in severity from simple ligamentous relaxation to fixation of the foot in calcaneovalgus. Much confusion exists in medical literature about these feet because different writers have described different degrees of this deformity.
The patients with milder deformity often show generalized relaxation of the subcutaneous tissue and of ligamentous structures—the so-called Ehlers-Danlos syndrome.2 The more severe ones frequently
KUHNS JG. CONGENITAL FLATFOOT. JAMA. 1942;120(5):329-333. doi:10.1001/jama.1942.02830400003002