common pediatric foot deformities affiliated foot & ankle center, llp dr. varun (ben) gujral...

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.