METATARSUS VARUS.

J/fETATARSUS varus, a common finding in in1'J fants, may be of very slight degree or it may be so marked as to make one consider pes equinovarus in the differential diagnosis. The condition is usually neglected unless the deformity is very striking, as there is a tendency for the foot to straighten, thus giving a more normal external appearance. Apparently the foot can appear quite normal even to careful examination until the child starts weight-bearing. Then a definite varus of the forefoot presents itself, usually with over-activity of the abductor hallucis muscle, so that the first toe in particular swings into medial position, with the inturn of the entire forefoot notably increased in comparison with the resting position. Perhaps the lack of attention to this condition lies in the fact that the literature contains reports stating that normal alignment is reached by the end of the first-year.5 In attempting to explain the cause of foot strain in adults and to understand why one individual might suffer from painful feet with or without such extrinsic evidences as corns, calluses, bunions, clawing, inversions or eversions, muscular spasm, and increasing loss of flexibility, while others can wear any type of shoe without discomfort, we became more interested in deviations from normal in children's feet. By careful roentgen examination of adult feet, we can rule out such congenital abnormalities as accessory scaphoids, coalitions, or specific disease which may be found in a small percentage of patients. However, in most instances, when dealing with the chronically painful foot, we can find variations in the forefoot consistent with failure of full evolutionary development.