Wednesday, December 26, 2012

Rocker Bottom Feet

Congenital vertical talus, also known as rocker bottom foot, is a rare deformity of the foot which is diagnosed at birth. It is one of the causes of flatfoot in the newborn. One or both feet may be affected. It is not painful for the infant, but if left untreated, it can lead to serious disability and discomfort.
The talus is a small bone that sits between the heel bone and two bones of the lower leg. The tibia and fibula sit on top and around the sides of the talus to form the ankle joint. The talus is an important connector between the foot and leg, helping transfer weight across the ankle joint.
In congenital vertical talus, the talus has formed in the wrong position and the other foot bones to the front of the talus has shifted on top of it. Because of this, the front of the foot points up and may even rest against the front of the shin. The bottom of the foot is stiff and has no arch. Usually it curves out, hence the rocker bottom phrase.
Vertical talus is sometimes confused with newborn flatfoot, or even as clubfoot. The exact cause of this deformity is not known, but many cases of vertical talus are associated with a neuromuscular disease or other disorder, such as arthrogryposis, spina bifida, neurofibromatosis, and numerous syndromes. Your doctor may perform tests to see if your infant has any of these conditions.
Treatment for vertical talus centers on providing your child with a functional, stable, and pain-free foot. It is crucial to have this condition treated early, as your child will learn to walk on an abnormal foot and painful skin problems will develop.
Nonsurgical treatment includes a series of stretching and casting designed to increase the flexibility of the foot and even sometimes correct the deformity. Some doctors will also prescribe continued physical therapy exercises to improve flexibility.
Surgical treatment, however, is the most common treatment. When nonsurgical treatment has failed, your doctor will recommend surgery between the ages of nine and 12 months. Surgery is designed to correct the aspects that cause the deformity, like problems with the foot bones, ligaments, and tendons that support the bones. The surgeon will put the bones in the correct position and apply pins to keep them in place. Tendons and ligaments may have to be shortened. A cast will be placed on your child's foot, and they may have to spend the night in the hospital. After four to six weeks, the cast will be removed and a special brace or shoe may be worn to prevent the deformity from returning.
With treatment, your child's foot should make a full recovery, allowing them to run and play without pain and wear normal shoes. Your doctor may recommend repeat visits throughout the years to monitor the development of your child's foot.
If your child is born with rocker bottom foot and has foot deformities, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

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Wednesday, December 19, 2012

Foot Deformity in Infants

Calcaneovalgus foot is also known as flexible flatfoot in infants and young children. In infants this foot disorder is seen with the foot abducted (turned) and the ankle severely dorsiflexied (twisted). Upon birth the foot looks like it is plastered against the front of the leg. A mild form of calcaneovalgus foot may be seen in 30% of infants, but the more severe form may be present in 1/1000 infants.
Calcaneovalgus foot is a common foot disorder which is a result of intra uterine positioning, and muscle imbalancing, which happens because of weakness of plantarflexors.
Calcaneus indicates that the heel is downward, and the ankle is flexed upward. Valgus refers to the heel turned outward. Calcaneovalgus feet are often called "packaging problems" because the structures were normally formed, but were deformed in the uterus because of crowding. It is commonly seen in first-born children and females.
Diagnosis is made by physical exam. The feet have a classic appearance with the feet bent upward, and the heel bone should be palpable to the heel pad in a twisted position. There should be good ankle motion, but may be limited by tight anterior structures. There should also be good flexibility in the hindfoot and forefoot. It is important to verify the flexibility of the foot and ankle.
Treatment can often be very simple. Gentle stretching and massage will help mobility and appearance. Within one to two months, the feet will have improved. In serious cases casting, followed by stretching exercises and an AFO splint for additional months may be necessary.
Most infants have a full recovery with recommended treatment. Rarely there is an external rotation alignment issue to the legs as the child begins to walk, but this typically corrects itself over time.
If your child is born with calcaneovalgus foot and has foot deformities, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

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Wednesday, December 12, 2012

Amniotic Band Syndrome and the Feet

Amniotic band syndrome is a congenital disorder caused by fetal limbs or digits getting caught in fibrous amniotic bands while in utero. Amniotic banding happens in every 1 in 1,200 live births and is likely responsible for 178 in 10,000 miscarriages. About 50% of cases also have other congenital deformities, including cleft lip, cleft palate, and clubfoot. It is considered an accidental occurrence and does not appear to be genetic or hereditary.
Constriction of appendages by amniotic bands may result in:
  1. Constriction rings around the digits, arms, and legs.
  2. Swelling of the extremities distal to the point of constriction.
  3. Amputation of digits, arms, and legs.
Many who have ABS will have clubfoot, which occurs in roughly 31.5% of cases. Disfigured feet in general are a common deformity in this disorder.
Some researchers believe that ABS is caused by early amniotic rupture, which leads to the formation of fibrous strands that entangle limbs and appendages. Treatment occurs after birth and involves plastic and reconstructive surgery, ranging from the simple to the complex. Prognosis depends on the location of the amniotic bands. Bands that are wrapped around fingers, toes, feet, or hands can result in syndactyly or amputations of the affected area.
If your child is born with Amniotic Band Syndrome and has foot deformities, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

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Wednesday, December 5, 2012

When To Call A Podiatrist

People call a podiatrist for help diagnosing and treating a wide array of foot and ankle problems. Please contact one of our six offices if you experience one of the following:
  • Persistent pain in your feet or ankles.
  • Changes in the nails or skin on your foot.
  • Severe cracking, scaling, or peeling on the heel or foot.
  • Blisters on your feet.
There are signs of bacterial infection, including:
  • Increased pain, swelling, redness, tenderness, or heat. 
  • Red streaks extending from the affected area.
  • Discharge or pus from an area on the foot.
  • Foot or ankle symptoms that do not improve after two weeks of treatment with a nonprescription product.
  • Spreading of an infection from one area of the foot to another, such as under the nail bed, skin under the nail, the nail itself, or the surrounding skin.
  • Thickening toenails that cause discomfort. 
  • Heel pain accompanied by a fever, redness (sometimes warmth), or numbness.
  • Tingling in the heel; persistent heel pain without putting any weight or pressure on your heel.
  • Pain that is not alleviated by ice or over-the-counter painkillers, such as aspirin, ibuprofen.
  • Diabetics with poor circulation who develop Athlete's Foot.
If you have a foot problem, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.


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Wednesday, November 28, 2012

What Is Jackson-Weiss Syndrome?

Jackson-Weiss Syndrome is a rare condition, so rare in fact there are no published statistics. The condition is a genetic disorder that is caused by a mutation in chromosome 10, the FGFR10 gene, and is responsible for defects in the face, feet, and head.
It affects both males and females equally and may appear as the first time in a family, or be passed down from generation to generation. Intelligence and life expectancy are typically normal. Babies born with Jackson-Weiss Syndrome have a skull that fuses together too early, called craniosynostosis. This causes a bulging forehead, misshapen skull, widely spaced eyes, and a very flat middle section of the face.
Foot deformities are common in those who have Jackson-Weiss Syndrome and may include:
  • Wide, short, big toes. 
  • Big toe bends away from other toes.
  • Bones of some toes may be fused together.
  • Webbing of toes.
Treatment is generally surgical and targets the specific deformity.
If your child is born with Jackson-Weiss Syndrome and has foot deformities, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.



Wednesday, November 21, 2012

10 Tips For Bunion Surgery Recovery

1. Even though it might be tempting and you feel up to it, avoid walking immediately after bunion surgery as it  may prevent proper bone and tissue healing.
2. During the first 3-5 days after surgery, keep your foot elevated as often as possible.
3. To keep inflammation down, ice your foot 4-5 times for 20 minutes throughout the day.
4. If your podiatrist prescribed a surgical shoe or walking boot for use after your surgery, make sure to wear it. The purpose of these shoes is to keep your healing toe in place. Walking too soon in street shoes will compromise your healing process.
5. Water and excessive moisture near the scar may introduce bacteria that can infect the fresh wound. When taking a shower or bath, wrap your foot in plastic bags with a rubber band to keep water out.
6. Take your full course of antibiotic medication to prevent infection.
7. If your podiatrist prescribes physical therapy to repair mobility in the joint, go for the prescribed length and be good about doing the stretches at home.
8. Talk with your podiatrist about what stretches you can be doing at home, if no physical therapy is prescribed.
9. Invest in several pairs of good quality shoes, sneakers, boots, etc. When your feet have the right support, the opportunity for foot deformities to occur or recur is less.
10. If you have the following symptoms immediately after bunion surgery, call your podiatric surgeon right away: fever, warmth and burning in scar area, inability to tolerate pain, or medication side effects.
Reference: http://www.healtharticles101.com/10-tips-for-successful-bunion-surgery-recovery/
If you have a bunion, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.


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Wednesday, November 14, 2012

Can My Child Have A Bunion?

When we think about bunions, we think of our mothers and grandmothers. Their feet, deformed after years
of wearing inappropriate shoes and having bad feet. But would we ever think of our young daughters? Juvenile bunions affect children and teens, especially girls, between the ages of 10 and 15. For the most part juvenile bunions are without symptoms of pain because they do not have the degenerative changes adults face. The first sign that your child may have a problem with a bunion is they will have trouble putting their feet into shoes. Some children will feel self-conscious about their bunions. Other symptoms will include:
  • A big toe joint that is red or swollen. 
  • Complaints of foot pain when walking, running, or playing.
  • Problems moving the big toe joint.
  • A thickening of the skin on the bottom of the foot.
Juvenile bunions are more severe as the onset of the foot deformity is earlier and it progressives very quickly. When left untreated, it can cause significant deformity and disability. They are typically treated aggressively to prevent recurrence in later years. Roughly 50% of juvenile bunions are associated with flexible flat foot, as the flattening of the arch and the large big toe are secondary to hypermobility of joints.
When it comes to foot wear and children, ensure your child does not wear ones that are too small or too tight. Young girls with juvenile bunions should stay away from heels and narrow/pointy shoes because this increases the risk for bunions to increase.
Treatment for a juvenile bunion depends on severity, degree of pain, and how quickly the bunion is progressing. Growth plates in children tend to close when girls are around the age of 16 and boys when they are 17. Closing of growth plates dictates when surgery can be accomplished safely.
Conservative treatment options for juvenile bunions include:
  • Custom orthotics, which control excessive motion
  • Changes in shoes, to take pressure off the bunion
  • Padding/taping, use to relieve irritation and discomfort
  • Anti-inflammatory medications to help with the pain.
  • Physical therapy to help with pain relief. 
If your child has a bunion, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.



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Wednesday, November 7, 2012

You Don't Have To Be A Bird To Have Claw Toes

Toe deformities often get blamed on wearing shoes that are too tight or too small, which can be the case in hammertoes and mallet toes. However, claw toes are the result of nerve damage from diabetes or alcoholism, which weakens the muscles in your foot. Claw toes claw at the soles of your shoes, creating painful calluses. Without treatment this deformity can become worse over time, even becoming a permanent problem.
Symptoms of claw toes include:
  • Toes that are bent upwards from the joint at the ball of the foot. 
  • Toes bend downward at the middle joints towards the sole of your shoe.
  • Toes may also bend at the top joint, curling under, like mallet toes.
  • Corns on the top of the foot or on the ball of the foot.
A podiatrist can effectively diagnose a claw toe, using tests to determine if the cause is neurological, or trauma or inflammation.
In the early stages of a claw toe deformity, the toe will be flexible. However, the longer the condition progresses, the more rigid it will become. If the deformity is caught at an early stage, simple taping or splinting may be prescribed to retrain the toe to the correct position. Your podiatrist may also recommend:
  • Wearing shoes with roomy toe boxes and avoiding tight shoes and high heels.
  • Use your hand to stretch the affected toe to the correct position. 
  • Exercise your toes by performing towel pick-ups or marble pick-ups with your feet.
Claw toes at an advanced stage will require other, more complex treatment:
  • A special pad to redistribute your weight and relieve pressure on the ball of your foot, like an orthotic.
  • Extra deep shoes with additional space in the toe box to accommodate the claw toe.
  • Have your shoes stretched.
  • Surgery to correct the deformity.
If you have a claw toe and are experiencing pain, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

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Wednesday, October 31, 2012

I Have A Long Second Toe!

If your second toe is longer than your first toe, you have a type of foot called Morton's toe, or Greek foot. It is a form of brachymetatarsia, which promotes an anterior position of the second toe in relation to the big toe. This deformity may or may not result in the second toe extending past the big toe.
The name Morton's toe was given by American orthopedic surgeon Dudley Joy Morton, who included it as part of the Morton's triad: a short first metatarsal bone, a hypermobile first metatarsal segment, and calluses underneath the second and third toes. Morton's toe can also be confused with Morton's neuroma, which involves a nerve between the third and fourth toes. Morton harkened back to prehistoric humans, who probably used their toes for grasping.
The Greeks believed this type of foot to be beautiful, and it appears in sculptures and art. As well, it persisted as an aesthetic standard through Roman, Renaissance, even modern times- the Statue of Liberty has a Greek foot!
Morton's toe is a common foot type, but can be considered a deformity as well. The symptoms associated with Morton's toe include discomfort and callusing along the top of the second toe. This is because the big toe would normally bear the weight of walking, but these forces are transferred to the second toe because of its length and position. With shoes it can be a problem when trying to fit a shoe to the second toe.
Morton's toe affects 20% of the population, but 80% of people with it have foot pain. The reason for this high ratio is because of excessive pronation (weight bearing). Excessive pronation causes the leg to be shortened or lengthened, and the leg is rotated internally. Other problems associated with Morton's toe are: metatarsalgia, hammertoes, mallet toes, bunions, Morton's neuroma, and heel pain.
Treatment is often orthotics to realign the foot to its proper position and relieve some of the pressure from the second toe.
If you have a Morton's toe and are experiencing pain, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.


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Wednesday, October 24, 2012

Mallet Toes: Not Something You Hammer With

A mallet toe occurs when the joint at the end of the toe will not straighten. This is different from a hammertoe because in a hammertoe, any joint can be affected. Excessive rubbing of the deformity against the top of a shoe will lead to the development of a corn and pain. The tip of the toe is often turned down against the shoe, causing pressure and discomfort. Those with mallet toes are often embarrassed by this deformity because it can stick out like a sore thumb. When left untreated, the pigment of the skin on the mallet toe can become dark and circular.
Causes of mallet toes include:
  • If you are on your feet all day. 
  • Participate in sports regularly.
  • Have arthritis
  • Have nerve damage in your back, leg, or foot.
  • Have very high or very flat arches.
  • Wear shoes that don't fit
  • Were born with a toe deformity.
Other factors include poor circulation, diabetes, edema, and wearing non-leather shoes. Complications of the mallet toe can lead to puss, infection, and swelling, as well as a change in gait pattern because of pain.
Conservative treatments for mallet toes include:
  • Wearing shoes with a large, square toe box.
  • A toe crest or buttress pad.
  • Gel toe caps or shields.
If your mallet toe is causing significant pain or has progressed to an infection, call a podiatrist to make an appointment. Surgical treatments a podiatrist may try are:
  • Amputation of the tip of the toe (only if gangrene or severe infection is present).
  • Joint fusion of the toe.
  • Partial bone/joint removal.
  • Flexor tenotomy or lengthening.
If you have a mallet toe, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.


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Wednesday, October 17, 2012

Overlapping and Underlapping Toes

Toe deformities are common in children. These conditions are generally congenital, with one or both parents with these problems. Toe issues are typically present at birth and will become worse over time. Unlike children who are "pigeon-toed", children rarely outgrow this deformity.
In infancy, toe deformities are not usually a sign of another condition. For parents, it's usually a cosmetic issue. But as the child grows, the toes transform from flexible to rigid and become symptomatic of another condition. Many toe deformities will respond to conservative treatment. Traditional treatment has been digital splitting and exercises, but those often do not lead to good outcomes. As the deformities progresses and the toes become more rigid, surgery is generally the only option.
Underlapping toes can be seen in both children and adults and typically affects the fourth and fifth toes. A special type of underlapping toes is called congenital curly toes, and is common among families. Toes three, four, and five may be affected.
The cause of the deformity is unknown, but may be due to an imbalance in muscle strength of the small muscles of the foot. Combined with a small abnormality in the placement of the joints of the foot below the ankle joint called the subtalar joint, it creates a pulling of the ligaments in the toes, causing them to curl. Weight bearing increases the deformity and the folding of the toes results in the formation of callus on the edge of the toe. Tight fitting shoes aggravate this condition.
Treatment depends on the age of the patient, degree of the deformity, and symptoms. When symptoms are minimal, most podiatrists will recommend waiting and seeing how the condition progresses. If surgery is required, the degree of the deformity determines the procedure. A flexible toe will only require a simple release of the tendon, but a rigid toe may necessitate the removal of part of the bone.
Overlapping toes are identified by one toe that lies on top of another toe. The fifth toe is most often affected, but the second toe can be as well. The cause of this deformity is not known as well, although it is speculated that the position of the fetus in the womb during development is a potential reason. Sometimes overlapping toes are seen in families.
Treatment for overlapping toes depends on how quickly the condition is diagnosed. For infants, passive stretching and adhesive taping is commonly prescribed. This treatment can take 6 to 12 weeks and recurrence of the deformity is likely. Like underlapping toes, this problem will rarely correct itself. Occasionally as the individual grows, the deformity will go away. If surgery is required, a skin plasty is required to release the contracture of the skin associated with the toe. A tendon release and release of the soft tissue around the joint at the base of the toe may also occur. Cases that are severe may require the toe to be held in place with a pin. The pin exits the tip of the toe and may be left in place for up to three weeks. During recuperation the patient must limit their activities and wear a surgical shoe or removable cast. Excessive movement will greatly affect the outcome of how the toe looks. Following removal of the pin splinting of the toe may be required for another two to three weeks.
If you have underlapping or overlapping toes, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.


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Wednesday, October 10, 2012

My Toes Are Webbed Like A Duck!

Webbed toes are when two or more toes are fused together. We typically think of animals, like ducks and frogs to have webbed toes, not humans. During our fetal development, we all have fingers and toes that are webbed. At six to eight weeks of development, an enzyme dissolves the tissues between our digits. But 1 in every 2,000 births results in webbed toes. Webbed toes can also be called duck toes, twin toes, or tiger toes.
The most commonly webbed toes are the second and third toes, and there are six types of webbed toes:
  • Simple. Adjacent toes are joined by soft tissue and skin only.
  • Complex. Bones of the toes are fused together. This is very rare.
  • Complete. The skin joins the toes from top to bottom. 
  • Incomplete. The skin is joined partially by skin, usually only to the first joint. 
  • Fenestrated. Skin is joined for most of the toe, but there is a gap in the middle. 
  • Polysyndactyl. There is an extra digit webbed to an adjacent digit.
This condition will not impair a person's ability to walk, run, jump, or swim, however many feel embarrassed or experience low self esteem.
The cause of webbed toes is unknown. Some people used to believe it was an inherited trait, but sometimes only one person in the family would have webbed toes. Studies suggest a woman's nutritional intake during early gestation and smoking during pregnancy may contribute to this deformity. Webbed toes are also associated with the following conditions:
Diagnosis may occur even before birth with a sonogram, or at birth. Additional symptoms indicate there is an underlying syndrome.
Webbed toes can be separated surgically, even though this condition does not cause any health problems (unless there is an underlying condition). Your doctor will use a skin graft from your thigh, which fill in the missing skin, to surgically separate your toes. Results will vary on the severity of the webbing and the underlying bone structure. Surgery will begin with general anesthesia and the surgeon marking off the areas that will be repaired. The procedure can last from 2 to 4 hours, depending on the severity of the condition. Most patients are required to stay in the hospital for up to 2 days after surgery. Many patients experience swelling and bruising, but that is normal. Pain medication will be prescribed to deal with the pain and discomfort. Once you are released from the hospital you will have to keep your bandages clean and dry for up to 3 weeks. Skin grafts can be very dry, and using lotion will help moisturize the area.
Complications of the surgery may include scarring and webbing growing back. There may also be post-operative swelling, severe pain, numbness, bluish discoloration, and tingling toes. If you experience any of these symptoms, call your podiatrist right away. Other complications include:
  • Skin graft damage, which may darken over time.
  • Breathing problems
  • Sore throat from tubation
  • Excessive bleeding
  • Infection
  • Bad reaction to medications
  • May need second surgery
If you have webbed toes, consider asking your podiatrist the following questions:
  • Will I pass this on to my children?
  • Do you recommend surgery?
  • What are the risks?
  • What tests should I anticipate?
  • Are there non-surgical treatment options?
  • What nutrients reduce the risk of my child having webbed toes?
If your child is born with webbed toes, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.



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Wednesday, October 3, 2012

My Child's Toes Turn Inward

Have you noticed when your child walks or runs, their toes turn inward instead of pointing straight ahead? This is called intoeing, or more commonly known as being "pigeon-toed".
You may first notice this when your child begins to walk, but a child of any age may show signs of intoeing. Severe cases of intoeing will cause the child to stumble or trip as they catch their toes on the other heel. There is not usually pain associated with this foot deformity, nor does it lead to foot arthritis, as is popularly speculated.
For the majority of children under the age of 8, this condition will correct itself on its own, without the use of braces, casts, surgery, or other special treatment. Children who are suffering from pain from their intoeing, or there are signs of swelling or a limp should be seen by a podiatrist.
The cause of intoeing typically comes from an alignment issue from some area of the body. Three common conditions associated with intoeing are:
  • Curved foot
  • Twisted shin
  • Twisted thighbone
These conditions often run in families, but can occur on their own or in conjunction with other orthopedic problems. Prevention is not an option since those conditions occur from developmental or congenital disorders.
Curved foot, or metatarsus adductus, is when a child's feet bend inward from the middle part of the foot to the toes. This is different than clubfoot, but severe cases may look like one. Some cases may be mild and flexible, but others may be severe and stiff. Curved foot typically improves on its own over the first 4 to 6 months of a child's life. Babies over 6 months who still have this condition, which may have progressed, may be treated with casts or special shoes. Surgery to correct the deformity is rarely used.
Twisted shin, or tibial torsion, is when the child's lower leg (tibia) twists inward. This can occur before birth, as the legs rotate to fit in the tight space of the womb. After birth, most infant's legs rotate to align properly. When the lower leg remains turned in, twisted shin occurs. As the child begins to walk, their feet turn inward because the tibia in the lower leg points the foot inward. The tibia can untwist as the bone grows taller. Tibial torsion almost always improves on its own, usually before the child goes to school. Splints, special shoes, and exercise programs do not work. If the child is 8 to 10 years old, with a severe walking problem or limp and still has this condition, surgery may be required to reset the bone.
Twisted thighbone, or femoral anteversion, is when the child's thighbone turns inward. It will appear most obvious when the child is 5 or 6 years old. The top part of the thighbone, near the hip, has an increased twist, which allows the hip to turn in more than it should. If you watch your child walk, both their toes and their knees will turn in. When sitting, children with this condition are often in a "W" position, with their knees bent and their feet flared out behind them. Most cases of twisted thighbone correct themselves, often spontaneously. Like tibial torsion, special shoes, braces, and exercises do not help. Surgery is not usually considered unless the child is 9 or 10 years old and the deformity causes tripping and an unsightly gait. Surgery involves cutting the femur and rotating it to the correct position.
If your child is suffering from intoeing, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.


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Wednesday, September 26, 2012

My Fourth Toe Is Very Short!

Brachymetatarsia is a condition in which one of the bones of the foot is significantly shorter than the others.
This condition typically affects the fourth toe. When looking at the foot, the fourth toe is much shorter than those surrounding it, and it may also appear as if it is raised up, with the third and fifth toes touching below.
The condition may be as a result of a congenital defect or an acquired defect. Congenital causes include Aarskog syndrome and Apert syndrome among others, along with acquired trauma. Simply, the metatarsal bone fails to develop fully, or the growth plate closes prematurely. This condition appears 25 times more in women (1 in 1820) than men (1 in 4586). 
Diagnosis is easily done with an x-ray of the affected toe. Usually patients come in with concerns about the toe's appearance, looking for cosmetic surgery to correct the abnormal shape and size, but often learn that there is a significant defect in the bone. Patients may notice that the toe is not carrying its share of the weight, which results in pain and discomfort. They may also have a difficult time selecting shoes because of the toe's shape. 
In many cases brachymetatarsia causes no pain or discomfort and will require no treatment beyond careful shoe selection. For some, surgery may be needed. 
If you are experiencing some of these symptoms, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

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Wednesday, September 19, 2012

Does Your Child Have A Clubfoot?

Clubfoot, one of the most common birth deformities, occurs in 1 out of every 1,000 live births and is when the foot turns inward and downward. It is congenital and may be passed down through families in some cases. Risk factors include a family history and being male.
The condition can range from mild and flexible to severe and rigid. Each case of clubfoot may appear different from child to child. It may also be difficult to place the foot in the correct position. The calf muscle and foot may also be smaller than normal.
The deformity is often diagnosed right after birth, when a foot x-ray may be performed to view the extent of the disorder. Often the problem is a very tight Achilles tendon, and a simple procedure can be done to release it.
Treatment should be started as early as possible, ideally right after birth when it is easiest to reshape the foot. The best method of treating clubfoot is moving the foot into the correct position and casting the limb to hold it in place. Recasting and gentle stretching will be done every week to improve the position of the foot. 5 to 10 casts are typically needed, with the final cast left on for 3 weeks. After the foot is in the correct position the child will wear a special brace all day for 3 months, then at night and during naps for up to 3 years.
Severe cases of clubfoot will require further surgery to correct the deformity if conservative treatments do not work or if the problem returns. A small number of defects may not be completely fixed and treatment will only improve the appearance and function of the foot. These cases are usually associated with other birth disorders. The child should be monitored by a podiatric physician until the foot is fully grown. Most cases are resolved with conservative treatment and the outcome is excellent.
If your child is being treated for clubfoot, call your podiatrist if you see any of the following:
  • The toes swell, bleed, or change color under the cast. 
  • The cast is causing the child pain.
  • The toes disappear into the cast.
  • The cast slides off.
  • The foot begins to turn in again after treatment.
For more information about clubfoot, visit our website, or make an appointment in our Glastonbury or Middletown locations.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.


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Wednesday, September 12, 2012

What Are My Options For Bunion Surgery?

You and your podiatric surgeon have decided that your painful bunions need to be surgically removed. Since there are so many options for removing the bunion, how does your podiatrist decide which one is best for you?
There are two ways a podiatrist selects which procedure is best suited for you. First, they will give you a clinical exam, which shows the range of motion available, the pain experienced with motion and footwear, and the mobility of the big toe and associated joints. Then, they will look at your x-rays. From this they will see the positive or negative findings of arthritic change due to joint cartilage and bone, the angle between the big toe and the second toe, and finally the length and position of the big toe.
Most procedures will include a "bumpectomy", which shaves off the part of the bone that is sticking out beyond the natural line of your foot. Inner muscles of the great toe may also be cut to prevent the big toe from crossing over to the second toe.
In a situation where the joint is severely arthritic and painful, one of the joint resection procedures would be the best option for you. Joint replacement is an implant that allows for minimal and pain-free motion. Joint fusion is a fusion of the metatarsal bone and the big toe. Joint resection procedures greatly reduce and even eliminate the pain associated with the bunion, but can also greatly decrease the range of motion.
For those who have a mild to moderate bunion, with a slight angle between the first and second toes, the surgical procedure usually involves moving the head of the metatarsal inward by making a sideways triangular cut called an Austin, or modified Austin. Once the cut has been made, the first toe is moved back towards the second toe and fixated. The benefits of this procedure is that there is a faster recovery time, easier healing, and the correction is very stable. The downside is that this procedure is only for mild to moderate bunions.
Moderate bunion procedures involve the shaft of the metatarsal. If the angle of the metatarsal is too great for a head procedure, meaning that the head could not be moved over for correction and be considered stable, then your podiatrist will instead make a cut in the shaft of the metatarsal, allowing for less movement and more correction. The benefit of having this procedure done is the angle of your big toe will be closer to what it used to be and the base of the toe will likely be hypermobile. Cons include a longer recovery, less stability, and a greater surgical expertise.
A base procedure is done when there is a very high angle between the first and second metatarsal. A metatarsal base procedure allows for slight movement inwards and great angle correction.
If you are suffering from a bunion, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.


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