Common Pediatric Foot Deformities Affiliated Foot & Ankle Center, LLP Dr. Varun (Ben) Gujral 2163 Oak Tree Road, Suite 108 Edison, NJ (732) 662-3050 www.footdoctorsnj.com
Anatomy/Terminology 3 main sections Hindfoot – talus, calcaneus Midfoot – navicular, cuboid, cuneiforms Forefoot – metatarsals and phalanges
Most Common Foot Problems Warts (Verruca) Ingrown Toenails Athletes Foot Heel Pain Sprains & Fracture Growing Pains???
Plantar Warts Cause: HPV virus Treatment: Debridement and Acid Therapy
Pain with Drainage (Pus) Causes: Tight Shoes, Trauma, inherited Treatment: Removal and Antibiotics
Athlete’s Foot (Tinea Pedis) Causes: Fumgus Likes to grow in Dark and Moist places (ie Shoes) Treatment: Topical Antifungal
Heel Pain Calcaneal apophysitis. Also known as Sever's disease, Tendo-Achilles bursitis. (such as juvenile rheumatoid arthritis), or wearing poorly cushioned shoes. Overuse syndromes.One common overuse syndrome is Achilles tendonitis. Fractures. Sometimes
Sprains and Fractures Causes: Slip and fall, sports, playing Treatment: Immobilization to Surgery Depending on severity
Anatomy/Terminology Varus/Valgus
Calcaneovalgus foot
Talipes Equinovarus (congenital clubfoot)
Different Treatments
Pes Planus (flatfoot)
Pes Planus (flatfoot) General - refers to loss of normal medial long. arch - usually caused by subtalar joint assuming an everted position while weight bearing - generally common in neonates/toddlers B. Evaluation - painful? - flexible? (hindfoot should invert/dorsiflex approx 10 degrees above neutral - arch develop with non-weight bearing pos?
In-Toeing General - common finding in newborns and children - little evidence to show benefit from treatment
In-Toeing B. Evaluation - family hx of rotational deformity? - pain? - height/weight normal? - limited hip abduct or leg length discrepancy? - neuro exam C. 3 main causes (i) metatarsus adductus (ii) internal tibial torsion (iii) excessive femoral anteversion
In-Toeing metatarsus adductus - General medially deviated midfoot normal hindfoot, medially deviated midfoot diagnosis made if lateral aspect of foot has “C” shape, rather than straight
In-Toeing (ii) Internal Tibial Torsion usually presents by walking age knee points forward, while feet point inward
In-Toeing (iii) Excessive Femoral Anteversion both knees and feet point inward presents during early childhood (3-7yrs) most common cause of in-toeing
In-Toeing (iii) Excessive Femoral Anteversion int rotation 70-80 deg ext rotation 10-30 deg “W” position
Treatment Options Custom orthotics & Bracing to correct or aid in the deformity correction Surgical Intervention
Our Services On-Site Digital X-ray Diagnostic Ultrasound On-site Physical Therapy for faster rehab Custom Orthotics Mini Procedure room Same day consulatation report/update for Doctor review
Take Home Points Foot pain is not normal Most ailments are easily treatable and can improve patients level of pain free activity We look forward to being an extension of your practice in the treatment of mutual patients.
Thank You!!!!!!