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Hi all!

It's my first time asking here but not cause I'm an expert in podopaediatrics...I need an help for my little patient.

I attach the images.
The Patient is 4 yo, no sports, no pain but the parents bring me the child cause he walk "on the inside"....

He has good QOM and ROM on the STJ and ankle joint.

Bad QOM and really limited mobility on both feet in nav-cun and cun-met joint.

Heel raising doesn't allow STJ supination.

All the gait rockers are almost fully pronated.

The good mobility at the STJ made me think that with a good orthotic he could get better until I saw the Rx.
I really don't like that talus positioning.

I really don't even know where to study which is the "normal"(i.e. most frequent) radiographic development of a 4 yo male child but looking at Talus plantarflexion I think that this foot risk to became a CONVEX PES VALGUS.

I tried to work on him with FMT (foot mobilisation technique) to see if could get better and to take time to think what to do. I think that an orthotic or other conservative treatment are not enough.
I don't know what to do.

Thanks for help.

fabio