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Pediatric Foot and Ankle Deformities

Some of the more common pediatric deformities are clubfeet, flat feet, and intoeing. Club foot is a congenital foot disorder easily recognized at birth. Treatment consists of corrective casting and or rarely surgery. Intoeing can result from malposition of the hip, leg or foot. Tripping and awkward gait are the usual complaints of the parents. Treatment depends upon the age, severity, and anatomical location of the deformity. Exercises, casting, night splints, or rarely surgery may be prescribed. Flat foot is a term used to describe any condition causing the arch to be abnormally low or absent. In children up to three years of age, the foot may appear to be flat due to a large fat pad in the arch and the cartilaginous nature of some of the bones in the foot. These feet are normal. A mild flat foot with no symptoms usually requires no treatment. However, those with severely flat feet or flat feet with associated symptoms; such as growing pains, leg, ankle, or arch pain should be evaluated. Treatments may consist of shoe modifications or orthotics (custom arch supports), and, in some cases, physical therapy. Surgery is only rarely needed.

Foot deformities in children should not be ignored. Early evaluation by a trained Foot and Ankle specialist in Pediatric deformities may prevent foot problems later in life.

Foot and Ankle Arthritis

Arthritis is among the leading causes of disability in the United States. It can occur at any age, and literally means "pain within a joint." As a result, arthritis is a term used broadly to refer to a number of different conditions.

Although there is no cure for arthritis, there are many treatment options available. It is important to seek help early so that treatment can begin as soon as possible. With treatment, people with arthritis are able to manage pain, stay active, and live fulfilling lives, often without surgery. However, in some advanced stages, surgery may be the best option.

Ankle Distraction with External Fixator

Ankle distraction arthroplasty is an innovative procedure for treating ankle arthritis in select patients. Unlike ankle fusion and ankle replacement, distraction arthroplasty focuses on joint restoration. These other procedures, while appropriate in many cases, sacrifice the ankle joint in an effort to decrease pain from arthritis. Distraction arthroplasty uses mechanical unloading of the diseased joint to reverse the effects of arthritis and significantly lower pain without damaging the ankle joint. Additionally - and importantly - ankle motion is preserved. Ankle distraction is, by no mean, a definitive treatment for arthritis, but can put off joint-destructive procedures for many years.

Ankle Arthroscopy

Ankle arthroscopy is a surgical procedure that uses a fiber-optic viewing camera and small surgical tools to operate in and around the ankle joint through small incisions. Ankle arthroscopy is performed for the surgical evaluation and treatment of a variety of ankle conditions. Arthroscopic surgery can have a quicker recovery time than traditional open surgery.

promoting a fusion between the tibia and the talus. "Fusion" refers to bones growing together. Fusion is not only performed on the ankle, but also on other joints in the body that are severely painful.

Metatarsus Adductus

Metatarsus adductus, also known as metatarsus varus, is a common foot deformity noted at birth that causes the front half of the foot, or forefoot, to turn inward. Metatarsus adductus may also be referred to as "flexible" (the foot can be straightened to a degree by hand) or "non-flexible" (the foot cannot be straightened by hand).

It occurs in approximately one out of 1,000 live births and affects girls and boys equally.

Other causal factors include the following:

  • family history of metatarsus adductus
  • position of the baby in the uterus, especially with breech presentations

Tendon repair

Tendon repair is surgery to repair damaged or torn tendons.

The surgeon makes a cut on the skin over the injured tendon. The damaged or torn ends of the tendon are sewn together.

If the tendon has been severely injured, a tendon graft may be needed.

  • In this case, a piece of tendon from another part of the body is often used.
  • If needed, tendons are reattached to the surrounding tissue.
  • The surgeon examines the area to see if there are any injuries to nerves and blood vessels. When complete, the wound is closed.

The goal of tendon repair is to bring back normal function of joints or surrounding tissues following tendon damage.

Foot and ankle trauma

Foot and ankle trauma is extremely common no matter how young or old you are. Fractures, torn ligaments and tendons, sprain and strain, puncture wounds and toenail trauma, occur every day. Elite Foot and Ankle can help put you back together so that you can recover from your accident as fast as possible. Don't wait too long to seek medical advice after your accident or injury. Delaying treatment often only worsens the problem!

It is a mistake to avoid the podiatrist's office after an accident or injury. Many people walk in with broken bones or torn tendons without realizing how serious their problem is or that is can get much worse. Long term foot and ankle pain is often linked with ignored trauma.

Tarsal tunnel syndrome and neuromas

Tarsal tunnel syndrome (TTS) is a condition classified by chronic burning pain in the ankle caused by abnormal pressure on nerve roots. It is similar to carpal tunnel syndrome in the wrist and hand. The specific cause of tarsal tunnel syndrome should be identified before treatment is rendered. The main symptom of tarsal tunnel syndrome is tingling or burning pain while standing or walking that starts in the ankle and spreads to the toes. Pain is sometimes present at rest. The condition is diagnosed by tapping on the nerve in order to induce tingling sensation.

Treatment for tarsal tunnel syndrome depends on the cause of the pain but can include anti- inflammatory medication, orthotics, corticosteroid injections or surgery. Surgery is usually used as a last resort to relieve pressure on the nerve.

A neuroma is a painful swelling of a nerve, usually in between the metatarsal bones of the foot. Neuromas may occur after a nerve has been injured, either from a traumatic event or excessive pressure. Symptoms include sporadic pain; burning, tingling or numbness of one or more toes. Pain is often soothed by taking weight off the foot or by massaging the area. The treatment will be directed to the cause of the neuroma

Bunion s and Hammertoes

A bunion is a bone deformity caused by an increase in space between the big toe joint and the joint next to it (inter-metatarsal space). Bunions form when the 1st metatarsal bone moves out of place causing excessive friction with footwear. The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus.

Bunions can also lead to other toe deformities, such as hammertoe. A hammer toe or contracted toe is a deformity of the proximal interphalangeal joint of the lesser digits of the foot causing it to bend, resembling a hammer.

Short metatarsal

Brachymetatarsia is a condition in which one of the five long bones of the foot (the metatarsals) is abnormally short, resulting in a shortened toe. This condition usually occurs in both feet (i.e., bilaterally) and in the fourth toe. If it affects more than one toe, the condition is called brachymetapody.

In some cases, surgery is performed to lengthen the short toe. In this procedure, the short metatarsal is usually cut and a piece of bone is grafted between the two ends. When the graft heals, the metatarsal and toe are the correct size. In most cases, the toe's extensor tendons and the surrounding skin also must be lengthened to accommodate the repaired toe. The proper length can also be achieved using an apparatus, called external fixator, to distract the bone. The latter procedure is preferred.

Diabetic foot care and neuropathy

Diabetic neuropathy, a common complication of diabetes, is damage to the nerves that allow you to feel sensations such as pain. The nerve damage is often related to blood sugar being too high for a long period of time.

Diabetes-related nerve damage can be painful. But, most the time, the patient loses sensation to the lower extremities.

Adult Acquired Flatfoot

A variety of foot problems can lead to adult acquired flatfoot deformity (AAFD), a condition that results in a fallen arch with the foot pointed outward.

Most people, no matter what the cause of their flatfoot , can be helped with orthotics and braces. In patients who have tried orthotics and braces without any relief, surgery can be a very effective way to help with the pain and deformity.

Warts and Nail Disease

Warts

Plantar warts are tough, horny growths that develop on the soles of the feet. Contagious, they're caused by a virus entering through broken skin, and often spread via public pools and showers. Plantar warts are harmless and can be left untreated, but in many cases they're too painful to ignore. Topical salicylic acid may help, while burning, freezing, laser therapy and surgical removal are more aggressive options for more severe cases.

Nail Disease

Fungal nails occur when microscopic fungi enter through the nails. A fungal infection can make your nails thick, discolored and brittle. If left untreated, the nail infection won't go away -- and can be hard to treat. Thriving in warm, wet places, the fungi can be spread from person to person. Topical creams and medicated nail polish can help in mild cases, but antifungal pills are often tried in severe cases.