Children often present with a foot, leg, and ankle deformities at an early age. This can be seen by just looking at a child’s lower extremities but it can also be noted when the child begins walking at 18 months. The child may have difficulty walking, often falling as a result fall.
Lower extremity deformities in children are mostly congenital in nature and have a genetic predilection. Such deformities include, but are not limited to, coalition, pes planovalgus deformity (flexible flatfoot), pes cavus (high-arched foot), congenital vertical talus(rigid flatfoot), genu varum (bowed legs), genu valgum (knock knees), internal tibial rotation (when the tibia is rotated inwardly), external tibial rotation (when the tibia is rotated outwardly), hip abduction, hip adduction, scoliosis, and>metatarsus adductus(inward deviation of the forefoot in relation to the hindfoot).
The Importance of Early Treatment
It is important to address these problems at an early age. Many times, pediatric physicians will indicate that they will grow out of it of that it or that it does not need treatment. This is not true. If a child under the age of 1 presents a gross foot or ankle deformity, there may be significant etiological reasons. Serial casting can correct these deformities and prevent surgery when they are older. It may also prevent long-term arthritis, difficulty walking, and significant bony deformity that causes pain throughout one’s life.
If a child undergoes serial casting under the age of 1, their deformities can often be corrected. However, if we wait and the child begins to walk and has continued abnormalities, then we must perform bracing at night and give the orthotic therapy to prevent progression of the deformity and try to reverse the deformity.
We can often reverse a deformity with these braces if it is caught early enough. However, if it is not caught early enough and the child ages to between age 3 and 4 years old, often times bracing and orthotics cannot correct the deformity. They will then need to undergo soft tissue procedures.
If the child presents after the age of 5, likely we will have to wait until the child is older to perform a more aggressive bony-type surgery because soft tissue correction and conservative bracing and orthotics will not correct deformities.
If your child presents a lower-extremity deformity, do not hesitate or wait to call us so that we can evaluate the child properly.