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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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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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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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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