1.How is flatfoot treated in children?
For the treatment of flatfoot in children, it is necessary to talk about the types of flatfoot. Because the treatment of flat feet varies depending on its type. It is possible to generally divide flat feet in children into two. Flexible and hard flat feet. Flexible flat feet are a type of flat feet that are widely seen in society (around 15-20% on average) and do not cause any problems for a significant part of life. In this case of flat feet, the foot arch becomes flat when the child steps on it, but it is possible to see that the foot arch is formed when there is no load on the foot or by pulling the big toe backwards. This type of flat feet can improve over time, until the age of 8-10, as the foot muscles develop and the bone structure becomes clear. In addition, since flexible flat feet do not cause problems such as pain or wounds in the foot, there is no need for treatment, but insoles can still be used to provide psychological relief to the family or to benefit the pain that occurs in rare cases. However, it would be wrong to expect flat feet to improve by using insoles because it is possible to compare the relationship between flat feet and insoles to the relationship between eye disorders and glasses. Just as it is not possible to correct eye disorders by using glasses, it is not possible to correct flat feet by using insoles.
Hard flat feet, on the other hand, is a problem that can cause serious problems and pain in the foot. In this type of flat feet, there is a flattening of the foot arch whether there is a load on it or not. Pain, pressure sores and calluses may occur on the soles of the feet due to the disorder in load distribution. This type of flatfoot may have different causes such as oblique talus, vertical talus, tarsal coalition. It is not possible to correct hard flat feet with insoles. If a complaint occurs, it may be necessary to perform different surgical procedures depending on the cause.
2. How is introversion treated in children?
Introduction is a common condition in children. In fact, the problem here is not a foot problem, but a hip or shin bone (tibia) problem. Since the foot is only the last part, it is the affected organ. The problem here is the excessive hip rotation angle and or the increase in the inward rotation of the tibia. This problem is congenital and usually genetic. It does not cause any problems in the child except in very rare cases, but since it creates visual discomfort, solutions are sought by families. Most children prefer to sit in a frog or W shape. For this reason, our advice to families and children is to avoid this sitting position and to encourage cross-legged sitting. Introversion usually improves or decreases considerably as the child approaches adolescence. In very rare cases that persist even after adolescence and cause the child's feet to become entangled and fall while running, surgical correction may be required.
3. How to solve the crooked leg problem in children?
Crowd legs in children are physiological between the ages of 0-2, that is, it is an expected situation. Between the ages of 2 and 4, the legs begin to open outwards and regain their normal appearance after about the age of 4. Since this change in the legs is normal, no treatment is needed. However, not every crooked leg may be physiological, even in the 0-2 age range. Blount's disease, which is a rare disease, has a greater than normal curve in the growth cartilage at the upper end of the tibia and is a serious condition. Its treatment includes the use of knee braces and surgical correction surgeries.
4. How is heel pain treated?
Heel pain in children is a common problem between the ages of 9-12, when activity is intense. It especially occurs in children who are interested in sports such as basketball and volleyball that require jumping. The problem here is that the growth cartilage behind the heel does not fully connect to the main bone and ossify before puberty, leaving it as a weak area. As a result of the Achilles tendon attached to this area putting too much load on it during jumps, the weak attachment point becomes overloaded and can cause pain. In its treatment, it is important to stop the physical activity that causes it for a while. Since there will be edema and inflammation in the heel area during straining, ice therapy and anti-edema medications are important. After the acute painful period has passed, it is necessary to perform Achilles tendon stretching exercises in order to prevent its recurrence.
< p5. How to fix toe walking in children?Toe walking in children is always considered pathological and therefore it needs to be treated. In 90% of cases, there is no underlying cause, but the remaining may have central nervous system problems. Therefore, necessary research should be done. In cases where there is no underlying cause, it is recommended that families do Achilles tendon stretching exercises until the age of 3. If the condition persists despite stretching exercises, serial casting is performed. In stubborn cases, Achilles tendon release, which is a simple operation, is performed.
6. What is club foot in children?
Club foot (Pes equino-varus/club foot) in children is a serious problem and occurs during development in the womb. It is a problem that must be treated, and the earlier the treatment is started, the easier and more effective it is. Therefore, if detected, treatment should be started immediately after birth. The treatment for crooked feet in the first year after birth is serial casting. The chance of success in treatment with serial casting is around 90%. In delayed cases or cases that do not improve despite plaster treatment, release surgeries must be performed until the age of 2-3. With advancing age, the procedures become more complicated and correction may be required with bone surgeries.
7. How are foot and ankle problems treated in children with cerebral palsy? (Foot Equinus Deformity)
Foot problems in children with cerebral palsy are very diverse. The severity of these also varies. The most common foot problems are inversion (varus) and forward bending (equinus) deformities. If the varus deformity is a flexible deformity that can be corrected manually, muscle and tendon transfers can be performed. However, if there are hard deformities that cannot be corrected manually, it is necessary to correct them with bone surgery. Equinus deformity is generally flexible deformities. Correcting these is extremely important for general foot health. To correct this deformity, Achilles tendon lengthening surgeries or loosening surgeries from the muscle-tendon junction of the Achilles tendon can be performed.
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