Foot malformations in newborn or young children seen by physicians today are related to congenital defects that directly affect the structures of the foot or the nerves that control the lower extremities.
To understand the most common problems, it is first necessary to know the different types of alterations that the foot may show and how they are classified medically.
What are the alterations that a child’s foot may present?
A poorly formed or unnaturally positioned foot may show alterations in its longitudinal, horizontal or transverse axis.
In the case of longitudinal axis alterations we have the following cases:
- Thallus footIt is a congenital deformity in which the foot remains fixed “upwards”. This is because the bone that connects the foot to the leg (talus) is in an incorrect position. The prognosis is good and usually resolves spontaneously.
- Equinus footThe foot is held “on tiptoe” with a pronounced plantar flexion.
- Flat footThe plantar arch has little curvature, giving a flat appearance to the footprint.
- Pes cavusThe plantar arch of the foot shows a strong elevation. Fingers may remain flexed
The vertical axis alterations include problems such as:
- Adducted footIn this case the foot is placed out of alignment with the midline of the body.
- Varus footThe heel remains noticeably oriented inward.
- Valgus footThe heel is oriented markedly outward.
This is in addition to transverse axis alterations such as supination and supinationin which the sole of the foot is inclined 30 to 45 degrees inward, and pronation, in which the sole of the foot is inclined 30 to 45 degrees inward. pronationin which the angle of the sole points outward.
What are the most common congenital foot malformations?
We are going to detail the congenital foot deformities most frequently treated by pediatricians.
- Talus valgus footIt is one of the most frequent pathologies among foot malformations. It consists of the foot being in dorsal flexion and pointing at a pronation angle.
This condition may also occur as a result of the child having spina bifida or congenital hip dislocation.
This condition is corrected with physical therapy or by placing splints to fix the foot in an anatomically correct position, although in some severe cases cast bandages must be used to correct the position.
- Pes cavusAs mentioned before, it is a foot that shows a very pronounced plantar arch.
Sometimes it is accompanied by a deviation of the heel bone and the presence of retracted or claw toes. It generates pain because the stress of body weight falls entirely on the heel and metatarsal bones.
It is an uncommon pathology in children. Most symptoms manifest in adolescents or adults.
About 80% of cases of pes cavus are related to neuromuscular problems linked to genetic inheritance, such as cerebral motor injury, Charcot-Marie-Tooth disease and dysraphism of the spine.
Mild cases are treated with insoles to improve foot support and surgery is used when the deformity causes inability to walk.
- Congenital clubfootThe child’s foot is stretched forward, with contracted calves and very pronounced arch, resembling the feet of a ballerina standing on the tips of her toes.
It is more frequent in males, with an incidence of 4.5 cases per 1000 births.
- There are several possible causes for this problem, including familial inheritance, congenital dislocation of the hips, arthrogryposis or spina bifida.
- It is usually treated with corrective casts and physical therapy before the first three months of life. However, in 60% of children, surgery will be required to achieve correct foot position.
- Congenital flatfootThis is a flattening of the flattening of the plantar archaccompanied by pain and limitation of movement, which is present from birth.
This condition is treated with corrective casts and surgery, especially when the diagnosis is made late.
- Tarsal coalition as a cause of rigid flatfootTarsal coalition: The tarsal coalition is the union of one or more tarsal bones. In this case there is a fusion of the heel bone with the scaphoid bone. This anomaly results in a rigid flat foot. It is corrected with surgery.
Importance of early diagnosis
It is important to note that children are normally born with a relaxed, flat arch, called a physiological flatfoot. physiological flat footwhich takes its correct shape and firmness between 2 and 3 years of life.
In cases where flexible flat feet persist into adolescence and adulthood they can be treated with special inserts in their footwear or shoes with good internal support.
It is important for every parent to have their baby’s feet checked as soon as possible to determine whether or not there is any abnormality in the baby’s feet and attend to it immediately.
The vast majority of
children’s podiatric pathologies
can be totally or almost 100% corrected if treatment is applied before 3 months of treatment is applied before the age of 3 months.
Article prepared by Clínica San Román
Published on 22-2-2020