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I propose a new 1-4 classification of inherited foot structures based on foot embryogenesis. This classification is based on our current knowledge of human embryology.

• The ontogenetic (torsional) unwinding (saggital plane) of the cuboid determines the adult position of the embryological lateral column of the foot.
• The ontogenetic unwinding of the talus determines the adult position of the embryological medial column of the foot.

Clubfoot Deformity: the ontogenetic unwinding of the entire lateral column of the foot ends prematurely.

PreClinical Clubfoot Deformity: The cuboid completes its ontogenetic development but the calcaneus and talus remain in supinatus

Primus Metatarsus Supinatus foot structure: The calcaneus completes its' ontogenetic development, but the talus remains in supinatus (and along with it, the entire medial column of the foot).

Plantargrade foot: The talus completes its' ontogenetic development

 

From a human embryological point of view Root's classification of foot types is an impossibility. For example, a rearfoot varum foot type, where only the rearfoot is in varum cannot occur when one reviews the oncogenetic development of the foot.

• That is, if a varus rotation is present in the rearfoot (calcaneus supinatus) then a varum rotation (talus supinatus) must concurrently exist in the forefoot.

If you disagree, let's hear it.

 

When I was in my second year of Podiatry, my curriculum included a semester of Embryology. At the time I thought that was the most irrelevant and boring course I had to endure during that year. How wrong I was!

Embryology encapsulates the core understanding of foot pathology. It explains what can and what can not occur when ontogenesis goes wrong. If we had only embraced embryology with the same fervor we embraced Root's Biomechanics!