What is New in Pediatric Orthopaedic Foot and Ankle

Abstract

Background: This paper aims to report on the last 5 years of relevant research on pediatric foot and ankle pathology with specific focus on clubfoot, congenital vertical talus, toe walking, tarsal coalitions, pes planovalgus with or without accessory navicular, foot and ankle trauma, and talar dome osteochondritis dessicans. Methods: The Browzine platform was used to review the table of contents for all papers published in the following target journals related to the treatment of pediatric foot and ankle conditions. Search results were further refined to include clinical trials and randomized controlled trials published from March 1, 2015 to November 15, 2021. Results: A total of 73 papers were selected for review based on new findings and significant contributions in treatment of clubfoot, congenital vertical talus, toe walking, tarsal coalitions, pes planovalgus with or without accessory navicular, foot and ankle trauma, and talar dome osteochondritis dessicans. Also included were several papers that did not fit into any of these categories but provided new insight into specific foot and ankle pathologies. Conclusions: Treatment strategies for children with foot and ankle pathology are continually evolving. We review many of the most recent publications with the goal of improving understanding of these pathologies and highlighting current best practices. Level of Evidence: Level III.

Corrective bandages and daily manipulations for treatment of congenital vertical talus: a thirteen year follow-up

“…Other authors have reported positive results with conservative treatment in isolated cases of CVT [1]. A critical review addressed the efficacy of conservative treatments for the flexible flat foot in children [2]. Conservative treatment of the flat foot in children has mainly involved in-shoe foot orthoses and orthopaedic footwear for the flexible flat foot.…”

“…Conservative treatment of the flat foot in children has mainly involved in-shoe foot orthoses and orthopaedic footwear for the flexible flat foot. Exercise for flat feet has also been described, but in the form of barefoot time and prescribed activities [2,8].…”

“…Congenital vertical talus (CVT) is a rare foot deformity, occurring in about 1 in 10,000 [1] to 1 in 150,000 births [2], in which there is a rigid and irreducible dorsal dislocation of the navicular bone on the talar head, with the talus fixed vertically, the hindfoot equinus, and the forefoot dorsiflexed [3][4][5][6][7][8]. The aetiology is unknown in approximately 50% of cases; the remaining 50% being associated with neuromuscular disorders or other chromosomal abnormalities [9,10].…”

Ankle and Foot Deformities in Children

“…Children > 6 years of age require an open osteotomy of the medial cuneiform or the base of the first metatarsal, followed by an osteotomy of the second through the four metatarsals. 32 33…”

“…31 Treatment in newborns is usually conservative, based on physical therapy, with casting and splints applied to the leg an open osteotomy of the medial cuneiform or the base of the first metatarsal, followed by an osteotomy of the second through the four metatarsals. 32,33 Flatfoot Deformity Flatfoot deformity is a complex and variable deformity that clinically includes exaggerated plantarflexion of the talus, subtalar eversion during weight-bearing, and a combination of valgus, external rotation, and dorsiflexion of the calcaneus relative to the talar head. The navicular bone becomes abducted and dorsiflexed relative to the talar head, drawing the entire midfoot and forefoot into abduction and supination relative to the hindfoot.…”