The foot: anomalies and footwear

Clubfoot

Also called clubfoot. It is a congenital malformation of the foot in which it appears pointed (equinus) and with the sole turned inwards (varus).

It occurs in 1 out of every 1,000 children and is bilateral in half of the cases. It is more common in children.

The cause of why it occurs is unknown. Some theory tries to prove its origin. It is thought that it has a genetic or family cause or that it is due to a lack of space in the uterus during pregnancy that causes alterations in the growth of the foot.

What is clear is that it is a common condition in children with other neuromuscular malformations.

It is an anomaly that is diagnosed at birth by looking at the shape of the foot and verifying that a simple manipulation is not capable of obtaining a normal position of the foot. It can be diagnosed during ultrasound checks of pregnancy.

The treatment must be applied as soon as possible to obtain better results and avoid surgical treatment.

The most recommended treatment is established in the first days of life, placing corrective casts. The bones of the newborn are very soft and have a high capacity for remodeling, therefore, with the appropriate treatment, the clubfoot can be completely corrected.

If in two months the correction of the foot is not achieved, a surgical intervention must be carried out to lengthen the Achilles tendon.

Flat feet

They are the feet that present a wide area of ​​contact of the plant with the ground, with a decrease in the arch of the foot.

There are many degrees of severity. The plantar arch develops during the first 6 or 7 years of life. There are children with significant joint laxity and have flexible flat feet that do not cause problems or need to be treated. Flexible flat feet are the most common presentation of flat feet and can be corrected when the child stands on tiptoe. In these cases there is no need to use templates.

The flat foot that is treated is the one with associated bone malformations, progressive deformity and pain. The treatment is not with templates but surgical. They are a minority of cases.

Insoles only modify the support of the sole of the foot and are not capable of correcting the deformity.

Talus valgus foot

Foot that is bent forward and up, so that the tip of the foot touches the front of the leg (talus foot); when it is also deviated outwards it is called talus valgus.

It is the most common intrauterine postural deformity, common in situations where there is little amniotic fluid, the fetus is very large, or the presentation is breech.

The diagnosis is made at birth and in newborns with this malformation, it is necessary to ensure that there are no other associated malformations such as congenital hip dislocation.

It usually does not need specific treatment and it resolves spontaneously. The correction can be accelerated by stretching the feet until they return to the normal position. Only in severe cases are corrective splints necessary.

Footwear in children

Footwear is a garment that warms the foot and protects it. It is not essential, many children in the world go barefoot and the shape of the feet does not vary from one to the other. Footwear should not be seen as a treatment capable of correcting deformities or preventing alterations in the adult.

Children should walk barefoot whenever possible (when the weather and soil conditions allow it, for example at home or on the beach). It is a way to strengthen the muscles of the foot.

The right shoes don't have to be the most expensive. Children should not wear orthopedic shoes or inserts if they are not recommended by the child orthopedist.

The characteristics of footwear in children are:

• Adequate size, wide to avoid compression on the foot, preferably with a square shape so as not to compress the toes

• Flexible to allow movements

• The material from which it is made must allow the foot to breathe: leather or fabric, to avoid skin maceration and fungal infections

• Flat and without heel

• Light

• In young children, the heel must be firmly attached to the ankle to prevent the foot from coming off when the child runs.

• Children can wear sandals, sandals, sports shoes, shoes