Flexible Flat Feet In Children

Their feet are slowing

them down?

Your feet can dramatically affect your quality of life

Misaligned feet are NOT a good thing – even if you don’t have low or flat arches.

Foot alignment is critical for standing, walking and running.

WHAT ARE FLAT FEET?

• A common problem affecting millions of children and adults.

• Typically, there is a lowering of the arch.

• This condition is usually ignored and patients are told they will simply out-grow this condition.

The reality is very different.

Normal

Not Normal

• Pes Planovalgus– This is a complex situation where there are many

bones of the foot that are out of alignment.

• Talotarsal Joint Dislocation– This is also a pathologic condition where the ankle

bone partially slips of it’s normal alignment on the heel bone.

There are 2 medical conditions that can lead to a misaligned or flat foot.

Can we all agree that these are flat feet?

What’s the difference?

What’s the difference?

This is an example of Recurrent TaloTarsal Joint Dislocation

(RTTJD)The only difference between these images is one where the ankle bone is displaced on the heel bone and the other is where the ankle is where it is supposed to be.

This foot can be corrected with a rather simple solution.

The other…not so simple.

What do misaligned feet look like?

There appears to be 2 ankle bones on the inside of the hindfoot.

The ankle bone turns in-ward and the forefoot turns out-ward.

Ankle bone goes this way

Foot angles outward

Misaligned feet can also cause your knees to turn in.

Knees rotated in . . . instead of correctly aligned.

Misaligned feet lead to a chain reaction of damage throughout the body.

Aligned Feet = Aligned Body

Misaligned Feet = Misaligned Body!

Misaligned feet eventually lead to other symptoms.

“The more active I am, the worse my pain; the less active I am, the pain isn’t so bad.”

No Symptoms Yet?

• Imagine your foot acting as the tire on your car.

• You can place the tire (or foot) on the ground without balancing it.

• It functions great, for awhile.

BUT…

Alignment Matters!

• Sooner or later it will wear out.

• Not only is the single tire (or foot) affected, but it can adversely affect the other tires – or the rest of our body.

• The steering also becomes misaligned – just like our body.

The majority of people with misaligned feet DON’T have pain in their feet.

Instead, the pain will show up elsewhere, such as the knees, hips or back.

The symptom(s) of mis-aligned feet will show up at the “weakest link in the chain.”

Signs That Can Indicate Misaligned Feet in Children

• Child wants to be held/carried longer/more often than others, especially when walking.

• Child is not interested in sports or physical activities.

• Child is more clumsy or uncoordinated than others.

Signs That Can Indicate Misaligned Feet in Children

• Child runs significantly slower than classmates.

• Child’s shoelaces repeatedly come untied (due to movement & rolling of feet.)

• Child leaves shoes untied and/or doesn’t want to tie and re-tie shoes.

Signs That Can Indicate Misaligned Feet in Children

• Child experiences significant growing pains at bedtime, waking up shortly after falling asleep with pain or feeling pain as they fall asleep.

• Child is excessively overweight.

• Child has flat feet or “Too Many Toes Syndrome.”

What’s the Fix?

Treatment Option - Observation

Watching and waiting just leads to increased damage.

Instead of getting better, it gets worse.

Here’s what 50 years of observation would look like.

Benefit – Risk AnalysisObservation

• Benefits:– Non-surgical option– Relatively inexpensive – Does not rely on patient

compliance– No anesthesia/surgical

risks

• Risks:– Progression of the disease

process– Every step is inefficient– Excessive abnormal strain on

supporting soft tissue structures

– Mal-alignment to other structures within the foot & ankle and also up the musculoskeletal chain

– Possibility of long-term complications

Treatment Option - Orthoses/Shoes

• Arch supports can’t stabilize the ankle bone!

• They give a false sense of correction.

• The are NOT corrective, just supportive.

• Compliance issues – patient must wear them for them to be effective.

Treatment Option - Orthoses/Shoes

• Benefits– Non-surgical option– Initially relatively

inexpensive (but need frequent replacement)

– No potential anesthesia/surgical complications

• Risks– Not proven to decrease

tissue strain– Not proven to improve

radiographic measurements

– Can lead to other problems- increased pain

– Patient compliance issues– Need new devices made

regularly– Have to be worn in shoes

Treatment Option – Reconstructive Surgery

Is this really necessary? There has to be a better option!

Benefit – Risk AnalysisRearfoot Reconstructive Surgery

• Benefits:– Radiographic correction– Internal correction– Does not rely on patient

compliance– May be covered by

insurance companies.

• Risks:– Major Surgery– Surgical Risks

• Non-union• Infection• Need for revision• Need to remove internal

hardware

– Anesthesia Risk (low)– Expensive– Long recovery

Treatment Option –Extra-Osseous TaloTarsal Stabilization (EOTTS)

Internal Correction for RTTJD

• Minimally invasive, internal option• Permanent yet reversible • Used in both children & adults• Time-tested & evidence-based

Extra-Osseous TaloTarsal Stabilization (EOTTS)

A titanium stent is placed into a naturally occurring opening between the ankle and heel bones.

HyProCure® EOTTS

• HyProCure® is an internal bone stabilization device

• It prevents the abnormal collapse of the sinus tarsi

• Made of medical grade titanium

• Does not fragment or wear out

• FDA cleared/CE marked

Before

After

HyProCure® EOTTS

BENEFITS• Internal correction• Effectively stabilizes the ankle

bones• Not dependent on external

factors-shoes, braces, etc.• Should be a “permanent”

solution, but can always be resized or removed if needed.

• Proven to decrease strain on supporting tissues

RISKS• Stent displacement• Period of abnormal walking,

pain, swelling• Soft tissue adjustment• Need for stent removal• Other risks associated with

surgery.

HyProCure® - an Effective Solution for Children

Don’t Let Your Child’s Feet Slow Him or Her Down!

For more information, please visit:

www.AlignMyFeet.com

www.HyProCure.com or