Foot and ankle deformities in children with down syndrome

Abstract

PurposeFoot and ankle deformities are common orthopaedic disorders in children with Down syndrome. However, radiographic measurements of the foot and ankle have not been previously reported. The aim of this study is to describe the foot and ankle deformity in children with Down syndrome.MethodsChildren who had foot and ankle radiographs in the standing weight-bearing position were selected. Three groups of patients were identified. The relationship of radiographic measurements with age, body mass index and pain is discussed. In all, 41 children (79 feet) had foot radiographs and 60 children (117 ankles) had ankle radiographs, with 15 children overlapping between Groups I and II.ResultsIn Group I, hallux valgus deformity was seen before ten years of age and hallux valgus angle increased afterwards. Metatarsus adductus angle showed a significant increase (p = 0.006) with obesity and was higher in patients who had foot pain (p = 0.05). In Group II, none of the ankle measurements showed a significant difference with age or body mass index percentiles. Tibiotalar angle (TTA) and medial distal tibial angle (MDTA) were higher in patients who had ankle pain. In Group III, correlation analysis was performed between the different measurements with the strongest correlations found between TTA and MDTA.ConclusionIn children with Down syndrome, radiographic evaluation of the foot and ankle reveals higher prevalence of deformities than clinical examination. However, foot and ankle radiographs are needed only for symptomatic children with pain and gait changes.Level of EvidenceLevel IV - Prognostic Study

Abnormal Biomechanical Conditions of the Foot in Child with Down Syndrome During Standing: A Finite Element Study

“…The radiographic studies about the foot structure in DS children with pes planus showed large talo first-metatarsal angle, low navicular height and calcaneal inclination angle in their feet revealing abnormal alignment of the talonavicular and calcaneocuboid joint [5,6].…”

“…The radiographic studies about the foot structure in DS children with pes planus showed large talo first-metatarsal angle, low navicular height and calcaneal inclination angle in their feet revealing abnormal alignment of the talonavicular and calcaneocuboid joint [5,6]. Some studies pointed out that the ligament laxity and hypotonia caused by genetic issue are the main reasons for DS children's pes planus which induce abnormal alignment of foot [1,7,8].…”

Global postural evaluation and motor treatment in the subject with Down Syndrome: Clinical case reports

“…This is most evident in the lower limb where it is possible to detect, a valgism of the knees associated with pronation and flatness of the foot (about 58%). (Volman et al 2007;Perotti et al 2018).…”

Influence of a Foot Insole for a Down Syndrome Patient with a Flat Foot: A Case Study

“…Flat foot is also a common orthopedic complaint for patients with Down syndrome [1]. A previous radiographic study demonstrated that 58% of patients with Down syndrome have flat foot [2]. It is well known that the foot arch supports the body weight and decentralizes plantar pressure.…”

“…These physical problems can cumulatively result in a decline in gait function. The incidence of flat foot for patients with Down syndrome is estimated to be 27.0-58.0% [2,6]; 88.9% of these patients are treated with insole insertions [6]. It is known that inserting an insole as a treatment method for a flat foot is important and commonly used.…”