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Congenital split feet in children: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Congenital split foot deformity is a complex developmental defect, accompanied by the absence of one or more metatarsal bones and toes, a deep cleft along the entire depth of the forefoot.
ICD 10 code
Q66.8 Congenital split foot deformity.
Classification of congenital cleft foot
Depending on the severity of the lesion, mild, moderate and severe degrees of damage are distinguished. Mild deformation is characterized by the presence of a shallow cleft in the foot, reaching the diaphragms of the metatarsal bones, the absence of 1-2 toes while preserving all the metatarsal bones. With a moderate degree of deformation, the cleft in the foot ends at the level of the middle third of the metatarsal bones, one or two metatarsal bones are missing. Severe deformation is characterized by underdevelopment or absence of two or three centrally located toes and metatarsal bones, a deep cleft in place of the missing toes, reaching the Lisfranc joint, always accompanied by varus or valgus deformity of the toes, clinodactyly. Often, cleft feet are accompanied by other malformations of the forefoot - syndactyly, brachymetatarsia, congenital constrictions of the feet.
Treatment of congenital cleft foot
An indication for surgical treatment is severe and moderate split foot. Surgical treatment is performed on children from the age of one year.
Correction of foot deformities involves eliminating the cleft, creating an interdigital space, reducing the width of the foot by wedge-shaped resection of the tarsal bones and bringing the remaining metatarsal bones closer together using osteosynthesis with an autograft from the removed metatarsal bone or forming a bone bridge in the form of a petal bridge from the lateral surfaces of the metatarsal bones and other types of fixation.
The finger deformity is corrected by shortening resection of the phalanges of the fingers, capsulotomy of the interphalangeal and metatarsophalangeal joints with tendon transplantation and subsequent fixation with Kirschner wires and a plaster cast.
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