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Common Pediatric Foot Deformities
Affiliated Foot & Ankle Center, LLPDr. Varun (Ben) Gujral
2163 Oak Tree Road, Suite 108Edison, NJ
(732) 662-3050www.footdoctorsnj.com
Anatomy/Terminology
•3 main sections
1.Hindfoot – talus, calcaneus
2.Midfoot – navicular, cuboid, cuneiforms
3.Forefoot – metatarsals and phalanges
Warts (Verruca)
Ingrown Toenails
Athletes Foot
Heel Pain
Sprains & Fracture
Growing Pains???
Cause: HPV virus
Treatment: Debridement and Acid Therapy
Pain with Drainage (Pus)
Causes: Tight Shoes, Trauma, inherited
Treatment: Removal and Antibiotics
Causes: Fumgus
Likes to grow in Dark and Moist places (ie Shoes)
Treatment: Topical Antifungal
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
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)
A. 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
A. 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
(i) metatarsus adductus- General
• 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
Custom orthotics & Bracing to correct or aid in the deformity correction
Surgical Intervention
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
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.