Guest Blog Post by Dr. Lance Silverman of Silverman Ankle and Foot. 

 Ankle and foot conditions in children range from minor issues that resolve on their own, to serious issues that require surgery. Familiarize yourself with these common pediatric foot and ankle conditions so you can recognize them in your own children.

Metatarsus Adductus:

• This is described as a “foot twisted in” or a toddler with intoeing

• The condition is marked by a medial deviation of the forefoot on the midfoot (the line bisecting heel goes lateral to 3rd toe)

• In 95% of people, this corrects itself spontaneously

• See a doctor if it cannot be passively corrected by 3 months

Flatfoot:

• Flexible – Idiopathic

– Mobile subtalar joint (On tip toes, the heel turns in)

– Natural history studies  (“A flatfoot is a happy foot”)

– Hard sell to Mom

– Avoid Orthotics- only see a doctor for treatment if the condition is painful

• Rigid –  Multiple causes

– Fixed Subtalar motion (On tip toes, the heel stays out)

– #1 Cause:  Tarsal Coalition (Failure of differentiation and segmentation of hindfoot)

– Pain starts when cartilage begins to ossify, or the ankle/foot are sprained

– Treated with both non-operative and operative treatment

Cavus (High Arched) Foot:

• Neurologic Examination

– CMT, Polio, Lipomeningocele, tethered cord, spinal cord tumor

– Get Spine MRI if in question

• Natural History:  They get progressively more severe and rigid

– Surgery is routinely recommended as the best results are seen w/early osteotomy, muscle balancing, tendon transfers

Juvenile Hallux Valgus:  Bunion

• Maternal inheritance in 70% of cases

• Most learn to wear wider shoes – However, pain beneath the big toe is not improved with this method

• Surgery is recommended when shoe modifications fail and activities are restricted

About the Author:

Dr. Lance Silverman is an orthopedic specialist and founder of Silverman Ankle & Foot. He received his medical degree from Baylor College of Medicine in 1996 and is a board-certified member of the American Academy of Orthopaedic Surgeons and the American Orthopaedic Foot and Ankle Society.