General Medical Level A 6 year old white male presents with a history of an undiagnosed skeletal dysplasia.
Previous surgery includes bilateral femoral and tibial osteotomies for valgus deformities.
His knee alignment is now normal. His main complaint is the development of painful callus over the arch of his foot and difficult in fitting shoes. These deformities of the feet have been getting worse by the description given by the mother. His foot deformity has never been treated with casts or splints. On examination he has a short thick foot with a kidney bean shaped curve to its lateral border.