Pediatric flat foot deformity, actually you're not pediatric anymore but it was a pediatric
deformity, you were born with flat feet right? "Mhmm." So she started to have pain, we fixed this
about -- she's 19 now -- we fixed this I think when you were about 16? "Yes." About 3 years
ago I fixed this side. It was more of an emergency fix, we did a Kidner, went ahead and cleaned
that out, did a little transfer that's why the incision looks like this and a good old Evans
osteotomy right about here, put a little bone graft in there. This was about three years ago.
This is very recent to make it match so you see a little discoloration there.
The surgery for this was a little bit more extensive because well, more tendon tear,
but again we still went for the Evans right here.
I'm gonna watch the young lady stand and see how flat her foot is.
Okay, this is the young lady standing up right now, I understand this is --
how long ago did we do the right foot surgery? "Like a year, maybe 2 years ago now. The right one?"
The right one, the newest one. "Six months, seven months ago."
Six months ago, so we're gonna go into camera right here, see
now see she has an arch.
This is one was done three years ago, two or three years ago, she also has an arch.
Now before we had the surgery it was very flat no? "Yeah."
And it was very painful, that's why we did the surgery not because it was flat
but because it was painful. Am I correct? "Yes."
Let's turn your foot around,
all the way around, let me see you heel.
Now I'm looking at the calcaneal alignment that looks really good right now.
Again, the arch is good. Any knee pain or anything? "No."
Okay pick a side, face a side so we can see the side, yep and we're gonna turn right okay,
this is the -- again, the left one the one with the blue anklet we did that about three years ago,
again that she was having a lot of pain, that's the only reason why we did the surgery,
it was symptomatic.
And then we're gonna go ahead and turn the other way completely around
so we can see the other one.
This is the six months ago, beautiful arch.
Now the beauty of this is we're able to fix the tendon and transfer a tendon
as well as you know, similar to here we did a calcaneal graft, the cadaver calcaneal graft
called the Evans calcaneal graft.
We'll go over that a little bit later but yeah, it looks awesome.
How do you feel with it?
"It feels amazing. No pain."
Are you able are you able to run, walk?
"I am slowly able to run, yeah."
Yeah? Good. Now when you had the pediatric flatfoot, when you had the flatfoot
before we did any surgery on you, what were the symptoms?
"It hurt from like from my ankles to my knees
and then I felt like a bunch of back pain,
it was like the worst pain ever. I couldn't really work because of it."
And now you're able to be active, productive? "Yeah."
Do sports now, start --? "Yeah, starting to run again." Okay.
You met me through your father right? "Yeah."[laughs]
We fixed his ankle and everything. "Yeah."
So he's doing really good and now we've gotten you fixed already.
Anyone else in your family with the same? "No, not that I know of." [laughs]
Oh, thank God right? "Right." So face me one more time I'm gonna take a look at the --
this is the beautiful correction, I'm very happy with that. So any questions for me?
"No. I think that's it." We're good? "Yeah." I don't have to see you back for another year, sounds fair?
"Yep, that's perfect. " Perfect.
So as a recap, actually I have a better one -- I'll be right back on the scene --
so basically she had a Kidner foot, that little extra bone right here,
she had that so I took that little piece of bone out of here, reattached the tendon,
called it a day but the graft -- it's a calcaneal graft -- with the graft right here
to swing the foot over.
Now if you're flat-footed, if you see that you're flat, you can see that foot goes out.
So what we do is put the graft on the outside, it swings the foot back in.
It's a very powerful procedure. I'm going to go there on show you on this bone model.
Now, it's a very powerful procedure this calcaneus bone.
This is the navicular bone where the Kidner was, this is the calcaneus bone.
Make a little cut right here, open up the wedge, measure how big of a graft I need.
So when you're flat, your foot looks like this, this bone comes out.
When we put the graft there, it swings the foot underneath the leg again
or underneath the ankle.
So that was a proof positive that once you go like this your arch collapses
but once you put the graft there the arch comes back and you can see it in the young lady,
her arch just came back. She never had an arch.
Now she has arch, she's able to play sports, she's able to get around,
she's able to do her activities,
she has been able to do things that she has not been able to do before.
Took away her knee pain and her back pain, she's able to go about and be active.
So any problem with pediatric flatfoot, Kidner foot --
pediatric doesn't mean you have to be under 18.
You know we have some adults that had this, you know, you were born with a flatfoot
and no one addressed it, you know, a lot of times we don't.
I guess different specialties treat it a little bit differently,
sometimes we don't address it as aggressively as we should, but if you have any symptoms,
playing sports that is hindering your foot, you have shin splint,
you have continued pain, you really should see us,
a Board-qualified Certified reconstructive podiatric surgeon, foot and ankle surgeon,
not just a general physician, not a general orthopedist.
You need to see a specialist so we could assess if you qualify for any kind of procedure
such as Evans or sometimes we'll put a little implant in here,
that's still a little controversial, we put an implant, it works for some patients
or sometimes you just need a tendon repair or you need a combination.
The beauty of doing this early is that if we do it late, sometimes we have to fuse the joint,
take away the joint put screws and plates across it. That's the end stage.
We try not to get to that far especially when you're a child all the way up
into maybe 20s or 30s we try not to do that.
When you're older and it collapses and you have arthritic joint pain then we have to fuse it,
something called triple or double arthrodesis.
Those are something we do not like to do unless we absolutely have to.
We treat it early, we have orthotics to treat it, but it's not gonna reverse shift for your foot.
If surgery is needed seek out someone that's both qualified or certified to do the surgery.
As you can see, the results are marvelous if done correctly.
So at Family Foot and Leg Center, we keep you walking.
Give us a call at Naples, Florida. (239) 430 3668