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Congenital Disorders

Posted Nov 03 2009 10:02pm
Disorders of the foot and ankle are a common cause for orthopedic referral in infant, pediatric, and adolescent patients. The spectrum of problems is wide: While most, fortunately, are not serious, some of the congenital abnormalities do require significant operative intervention and a prolonged period of treatment. Even many of the less serious problems are a source of major irritation to patients because they often put limitations on the routine activities of daily living.

The following are common foot and ankle congenital disorders
Metatarsus adductus: Metatarsus adductus is a common congenital (present at birth) foot abnormality and is caused by a persistence of fetal positioning. It is one of the several congenital abnormalities known as a "packaging problem." "Metatarsus adductus" is a frightening sounding term but means simply that the metatarsals (the long bones in the mid-portion of the foot) are adducted, or angled toward the midline. As with any medical condition, metatarsus adductus can run the gamut from mild to severe. While one classification defines the degree of metatarsus adductus based on the amount of curvature, a better classification relies on flexibility. Feet are very supple and typically require no treatment. Those feet that are least supple require manipulation and stretching and the use of reverse last shoes, or perhaps a short period of corrective casting. Without treatment, most feet do spontaneously improve by age 3. After age 4, surgery may be considered to correct the residual deformity.

Clubfoot: Clubfoot is a more serious disorder that is not related to the intrauterine environment, but to a growth abnormality that can be strongly influenced by inheritance. The clubfoot is hooked like the adducted foot, but has true structural abnormalities that cause it to roll inward and point downward. Untreated, this results in a major disability. Treatment begins with casting; in about 40% of cases, minor surgical intervention is necessary for complete correction.

Congenital vertical talus: Congenital vertical talus is a fairly rare but serious condition. The position of the foot is a classic "rocker bottom." It must be differentiated from a hyper flexible foot, and if stiff, a cast is minimally useful and surgery is required.

If you notice your child is having any problems with her or her feet, please call Dr. Vail. He is here to help your child's feet be as healthy as can be.

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