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Foot Deformities
"Foot Deformity" is a general term for any condition that causes a structural alteration of the foot. Several common deformities are discussed below.
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Club foot (known as talipes equinovarus) is a congenital foot deformity that is immediately identifiable at birth or via a prenatal ultrasound. The club foot is pointed downward and rotated inward. The affected foot and calf are usually smaller than the normal foot.
Club foot is present in approximately one out of 2,000 live births and affects both feet in approximately 30 percent of cases.
Clubfoot is not a painful condition, and in most cases is easily corrected by weekly manipulation and long leg casting. A heel cord lengthening is frequently necessary for part of the cast treatment. Children wear special shoes during the day and night after the completion of treatment. In approximately 10 percent of cases, cast treatment is unsuccessful and surgical release is necessary.
Most children are able to walk normally, wear regular shoes and lead fully functional lives after successful treatment of club foot.
Metatarsus Adductus
This is a common birth defect in which a child’s feet curve inward from the mid-foot to the toes. The condition usually improves by itself.
If the condition does not improve by the time a baby is three-four months old, cast treatment is required. Treatment, which usually involves applying casts or special corrective shoes, has a high rate of success.
Tibial Torsion
This is in-turning of a child’s lower leg. The condition typically improves without treatment, usually before the age of four. Surgery is only considered if the condition hasn't correct by time the child reaches 8-10 years old.
Femoral Torsion
This is in-turning of a child’s upper leg. It becomes most apparent when a child is five-six years old and usually goes away by the time the child is nine or 10. Surgery is generally only considered if a child is older than nine and the condition is causing problems walking.
Haglund's Deformity of the Foot
Haglund’s deformity is a bony enlargement on the back of the heel that most often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone). In Haglund’s deformity, the soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes.
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Causes
Heredity often plays a role in Haglund’s deformity. People can inherit a type of foot structure that makes them prone to developing this condition.
High arches, for instance, can contribute to Haglund’s deformity. A tight Achilles tendon can also play a role in Haglund’s deformity, causing pain by compressing the tender and inflamed bursa. In contrast, a tendon that is more flexible results in less pressure against the painful bursa.
Symptoms
Haglund’s deformity can occur in one or both feet. Symptoms include:
- A noticeable bump on the back of heel.
- Pain in the area where the Achilles tendon attaches to the heel.
- Swelling in the back of the heel.
- Redness near the inflamed tissue.
Non-surgical treatment of Haglund’s deformity is aimed at reducing the inflammation of the bursa. While these approaches can resolve the bursitis, they will not shrink the boney protrusion at the root of the irritation. Non-surgical treatment can include one or more of the following:
- Medication. Anti-inflammatory medications may help reduce the pain and inflammation.
- Ice. To reduce swelling.
- Exercises. Stretching exercises help relieve tension from the Achilles tendon, especially for patients with a tight heel cord.
- Heel lifts. Patients with high arches may find that heel lifts placed inside the shoe decrease the pressure on the heel.
- Heel pads. Placing pads inside the shoe cushions the heel and may help reduce irritation when walking.
- Shoe modification. Wearing shoes that are backless or have soft backs will avoid or minimize irritation.
- Physical therapy. Inflammation can sometimes be reduced with certain forms of physical therapy, such as ultrasound therapy.
- Orthotic devices. Custom arch supports help control foot motion, which can lessen symptoms.
- Immobilization. In some cases, casting may be necessary to reduce symptoms.
Surgery may be indicated if the pain does not subside with conservative measures. Surgical options generally involve removing some portion of the heel bone to alleviate the irritation it causes against the tendon.
We Can Help
The podiatrists at Northwest Surgical Specialists are leaders in both conservative and surgical treatment of all foot and ankle disorders. For additional information, please contact one of our three convenient locations to arrange a consultation.
3100 W. Higgins Rd., Ste. 150
Hoffman Estates, IL 60169
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431 Summit Street, Suite 102
Elgin, IL 60120
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431 Lakeview Court, Suite D
Mt. Prospect, IL 60056
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Foot & Ankle Care