Definition and Overview
Pediatric foot deformations are abnormalities or deformities that affect the bones, muscles, tendons, ligaments, and joints of the foot. These are congenital in nature and may be caused by any irregularity that affects the embryonic development of the fetus. The majority of these conditions are easily recognized and diagnosed at birth, so there is an adequate time to seek treatment while the child is still young. Treatment options, such as splinting and surgery in early childhood, may correct the condition, helping the child live normally despite the congenital defect.
Cause of Condition
Pediatric foot deformations are believed to be caused by irregularities that affect the normal development of the foot while the baby is still in the womb. These deformities are thought to occur between the 6th and 14th weeks of gestation when the foot is forming, and the bones are calcifying.
Like other congenital birth defects, inborn foot deformities may be caused by:
- Genetic defects
- Chromosomal abnormalities
- Environmental factors affecting the mother during [pregnancy] (http://www.docdoc.com/info/procedure/pregnancy) including
- Exposure to chemicals
- Radiation exposure
- Exposure to secondhand cigarette smoke
- Health problems affecting the pregnant mother, such as:
- Heart disease
- Rubella or German measles
- Chicken pox
- Taking medications that are not safe for pregnant women
- Lifestyle habits of the pregnant mother, such as:
- Taking illicit drugs
- Consumption of alcohol
However, a large number of pediatric foot deformation cases do not have an obvious cause.
Pediatric foot deformations present in many ways and therefore also cause varying symptoms. Most of them are easily recognizable due to the physical appearance of the foot. However, there are some that may not be readily noticeable at birth but may begin to cause problems when the child begins walking.
The most common pediatric deformities affecting the foot include:
Intoeing – Intoeing is a condition characterized by toes that turn inward, making it difficult for the child to walk properly. This condition is related to the incorrect positioning of the hip, leg, or foot and treatment depends on the severity, specific cause or location of the deformity, as well as the child’s age during treatment.
Flat feet – A flat foot is when the child’s foot has a very low arch or has no arch at all. In mild cases, a flat foot will not cause problems and may even be considered as a normal foot. However, in severe cases wherein the arch is completely absent, it is possible for the patient to experience some symptoms, including arch pain, leg pain, ankle pain, and growing pains.
Clubfoot – This congenital foot defect is one of the most easily recognizable pediatric foot problems because of the unique appearance of the affected foot. In some cases, the condition affects both feet. The problem is believed to originate between the 9th and 14th weeks of gestation and is thus one of the deformities that can be detected on a routine ultrasound scan, allowing parents to plan treatment early. In fact, treatment may begin shortly after the child is born using the Ponseti technique wherein the foot is gently manipulated using casts and braces.
Cavus foot– Considered as the opposite of flat foot, a cavus foot is when the foot has an excessively high arch, causing the heel to turn inwardly. The condition places the patient at risk of pain, ankle sprains, and stress fractures. Also, this is a progressive condition that may get worse over time, so early treatment is highly advisable.
Tarsal coalition – This pediatric foot deformation becomes noticeable usually in late childhood when the growth and development of the foot begin to cause movement problems, such as pain and stiffness. In severe cases, this condition may require the surgical removal of the coalition tissue, replacing it with fat to prevent recurrence.
Accessory navicular – This condition is believed to begin at the point of embryonic development when the bone is calcifying. It is characterized by pain resulting from the movement of the two bones that normally should grow together. Treatment involves surgically removing the extra bone; when done correctly and at an early stage, this treatment can resolve the problem completely and for good, and may save the patient from chronic pain.
Who to See and Types of Treatments Available
Pediatric foot deformations are treated by a podiatrist. These problems need to be treated at the earliest possible time to keep them from getting worse. Although some cases may get better over time without medical intervention, children do not outgrow these problems in the majority of cases, and the deformities may cause more complex problems later on in life.
Seeking treatment during childhood gives the patient a better chance at overcoming the problem for good. Pediatric treatment of foot deformities uses techniques that gently manipulate the feet into the correct position, formation, or alignment. These treatments have a higher success rate during childhood, when the bones and soft tissues are still easy to adjust, and can effectively prevent complex foot problems from developing during adulthood.
Treatment of pediatric food deformation includes:
- Splints or corrective casting
- Exercise or physical therapy
- Occupational therapy
- Custom orthotic devices
- Custom arch supports
American Orthopaedic Foot and Ankle Society