Polydactyly
Polydactyly will often times require surgery so that the extra digit(s) can be removed. The surgery may be a soft-tissue or bony procedure, depending upon the underlying pathology.
Progressive Genu Valgus
Progressive genu valgus will require careful follow-up in the longer term, usually at 6 month-yearly intervals. Supporting the knee in a corrective knee brace is the initial management, but bracing does not obviate the need for surgery. Surgery is advised for angulations greater than 20o (less if the deformity is progressive in a young child). The bony deformity is corrected by an osteotomy and the leg is placed in an external fixator until the osteotomy heals. Recurrence over time is common and several corrective procedures may be necessary during childhood for severe deformities. In the older child nearing the end of growth, an alternative strategy is to slow down growth of the inner aspect of the tibia by a metal staple or stop growth completely by surgical removal of the growth plate. Elevating the under-developed part of the tibia has been performed in selected cases to restore knee alignment.