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Calcaneovalgus Foot

This is a one of the most common foot deformities in children (problem with the shape of the foot) wherein the foot points upward and outward. In extreme cases, the top of the foot touches the front of the lower leg. The condition is congenital, meaning your child was born with it. It may affect one or both feet. Calcaneovalgus causes the baby no pain, and often goes away on its own.

Signs and Symptoms

This foot defect, present at birth has no symptoms.

  • The foot is markedly dorsiflexed, with the dorsum of the foot resting against the anterior tibia.
  • The hindfoot is held in valgus and, occasionally, a contracture of the anterior muscles (dorsiflexors) is present.
  • The deformity usually is supple, and the foot can be passively plantarflexed easily.

Causes of Calcaneovalgus

The main cause is thought to be squeezing of the foot due to the child's being "packed" in the uterus during the last few months of pregnancy. Calcaneovalgus runs in families, and more girls than boys have it.

How Is Calcaneovalgus Foot Diagnosed?

Calcaneovalgus is easily found by looking at the foot when the child is born. The doctor will rule out other congenital deformities of the foot.

Treatment

Non Operative Treatment:

  • In most cases this foot abnormality resolves without treatment.
  • Occasionally plantarflexion-inversion casting is used in infant if spontaneous resolution is not seen w/in first few months of life.
  • Orthotics is of no proven benefit.
  • When there is muscle imbalance resulting from paralytic conditions, ankle-foot orthotics can control foot while child is small.
  • It is impossible to quantitate what constitutes flexible flat foot.
  • No device has been developed that predictably alters growth, development, or final adult configuration of a flexible flat foot.
  • It is difficult to determine how much pain or excessive shoe wear should be tolerated.

Surgical Treatment:

  • Results of surgery in the treatment of flexible flatfoot are extremely difficult to assess.
  • It has not been proven that the mere presence of a flexible flatfoot or calcaneal valgus requires some form of treatment.
  • Children may be candidates for tendon transfer (tibialis anterior to os calcis), &, or hindfoot stabilization by subtalar fusion is needed.
  • Older children may need a calcaneal elongation osteotomy in addition to tendon transfer & plantar fascia release.
  • Children over 10 years of age may require triple arthrodesis.

Long-Term Concerns

If diagnosed and treated, the child's foot usually works well and looks normal. If it doesn't go away, calcaneovalgus can cause problems with muscle development and walking. So your child should see the doctor for regular follow-up visits to be sure the problem goes away.

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