Good afternoon, thank you for joining me in this discussion about pediatric feet
particularly about flat feet deformity in a child.
Let's talk about the seven truths you may not know
about your child's feet.
Tip number one -- flat feet is not normal
but it does not always require
intervention by a physician.
Truth number two -- symptomatic flat feet should always be
seen by your physician or your foot andankle specialist.
Number three -- intoeing
also known as pigeon-toed is normal at a certain age but if persistent can be a
problem long term, any questions see your physician.
Number four -- flat feet can cause
heel, knee, back, and hip pain in a child.
Number five -- the tight Achilles tendon
can cause the flat feet to get worse.
Number six -- early intervention and evaluation
can help prevent painful surgery for your child.
Number seven -- sometimes an extra piece of bone
that your child was born with
may be the cause of the child's flat feet.
The reason for making this video is that
a lot of patients have asked me to talk about flat feet and particularly we see
a lot of a pediatric flat feet deformity where the concerned parent comes in and
say "hey, my child has flat feet" or a pediatrician will refer a patient to see us
for flat feet evaluation.
Sometimes the kids are asymptomatic,
sometimes they are very symptomatic.
So let's go over what a flat foot looks like on a bone model
and we'll discuss some treatment options from that point on.
We're gonna look at this normal
normal arch with the anatomy
as you can see the
almost like a long triangular shape of an arch, this provides a good
mix of shock absorption as well as stability of the foot.
Now we're gonna go
to a flat foot deformity
as you can see the arch is flat particularly we're
gonna see that this bone is very prominent on the bottom of the foot so
if you notice on the inside of your ankle
you can have a little prominence on here.
Another thing we've noticed that we see in this foot model.
I'm gonna hold it up together.
Not as easy to see but you'll notice that this foot right here
it's normal you see on the outer edge right here it's very nice and straight
and on this foot the outer edge bows out a little bit.
So that's why when people have flat feet
you see not only the flat arch with a prominent bone here
but you also see the foot pointing out towards the side so some people have a
waddle or duck gait.
So let's talk about this.
Again, not a lot of people need any kind
of intervention if they're asymptomatic but as a concerned
parent I can see why you want the best for your child and sometimes just proper
shoes are very important.
New Balance makes good shoes for kids.
Something with a nice support as I talked about in my
"How to choose shoes for your child"
this support right here is very important
it should never bend about the arch and
the shoes should bend around the toe area.
That is the most important
part of buying shoes for your child.
Again, my video talks about that
how to buy shoes for your child especially for back-to-school.
Now let's talk about that extra piece of bone.
That extra piece of bone is right about here
on this foot model. The tendon called the posterior tibial tendon
goes behind the ankle and goes into this bone
sometimes the first time a patient will notice this is if they're
playing sports and they twist their ankle
not in -- not twisting in this way but out
they twist not in but out and then they sprain this tendon on
the inside. Sometimes that's how I first get to see the patient for this type of
type of problem and we address the extra piece of bone.
It is also called a Kidner -- K I D N E R foot
that extra piece of bone can be very painful, very prominent, sometimes it
could be red and swollen on the inside of the ankle.
Basic treatment for that if
it's the first time having pain or symptoms after a traumatic injury
will be immobilization, ice, rest, physical therapy
and a lot of times the shoes are not supportive
so we go ahead talk about shoe gear and
custom orthotic therapy for the child.
Majority of the time, that's all it takes
but for the minority of patients
surgical intervention is required and the level of surgical
intervention needs to be determined by your
your chosen physician.
A very interesting fact
we're looking at these two bones -- these two foot models as
you can see the flat foot right here, normal foot, and how the normal foot has a
straight edge, the flat foot goes out this way towards the side
creating the waddle or duck-like gait.
So there is a surgical procedure called the Evans
E-V-A-N 'S
this is a tried-and-true method basically the
surgeon puts a bone graft on this side and it swings the whole foot back over straight.
That is a very easy tried-and-true method that's has been around
for quite some time and it's been very predictable,
the bone graft absorbs and
becomes a piece of your child's bone -- heel bone
and the flat foot is corrected majority of the time.
A newer procedure that's been on the horizon for quite sometime
and more popular one in the podiatric community versus the orthopedic community
although it is gaining more acceptance in the world of orthopedics is
something called subtalar joint implant.
This is a foot model
this is a normal foot with a nice arch but if it was flat you can see that this
bone would be collapsed
this bone would be collapsed, it's hard to tell but
there is a joint right here, there is a little pocket for the implant the
surgeon will stick an implant right here right into this joint to prop the
to prop the arch up so that way
so that way it doesn't fall and that has been a very
good procedure for mild
mild flat feet with mild symptomatology
without any involvement of the tendon or extra piece of bone.
That can be very effective.
Again, the selection of the procedure is very dependent on your chosen surgeon
and the amount of symptomatology of the child and if
they failed conservative care.
So thank you for listening to this video
hopefully I could provide more videos and educational material for you.
Please visit our website at www.NaplesPodiatrist.com
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anything you want to hear about hopefully I can help you address.