Tuesday, November 24, 2009

Books! Books! Books!

Check out these books (and many more) at the Findlay-Hancock County Public Library!

Amazing Animal Feet - Linda Bozzo
Let's Look at Feet - Simona Sideri
One is a Snail, Ten is a Crab: A Counting by Feet Book - April Pulley Sayre and Jeff Sayre
Feet - Dana Meachen Rau
Impatient Pamela Asks: Why Are My Feet So Huge? - Mary Koski
My Feet - Aliki

Our Website has many more educational features to learn about your feet! Check it out!

Thursday, November 19, 2009

Traumatic Injuries

Ankle Fractures
Ankle fractures in the skeletally immature usually involve the growth plates of the tibia or fibula (the two shin bones). They usually occur as a result of a twisting injury to the ankle. An adult with the same type of injury would have an ankle sprain (a tear in a ligament). Most of the ankle fractures seen in children do not require operative management, but do if the fracture line extends into the joint. Injury to the growth plate may, on occasion, result in a growth disturbance.

Ankle Sprains
Ankle sprains in children are rare because the ligaments are stronger than the growth plate, and the growth plate fails first under the "load" of injury. When they do occur, some form of immobilization (cast or brace) is indicated in order for the ligaments to heal at their normal length. Ligaments that heal in a "lengthened" position result in long-term disability and the increased likelihood of repeated ankle sprains under even minimally vigorous loads.

Please contact Dr. Vail for an evaluation of your child's feet - especially if you notice any of the problems mentioned above. Prevention is the key to helping your child to develop properly.



Thursday, November 12, 2009

Overuse Injuries

Achilles Tendonitis

Achilles tendonitis is an overuse injury seen rarely in children under age 14 but seen with greater frequency as skeletal maturity approaches. It is characterized by pain with activity, particularly jumping sports in the region of the Achilles tendon. Rest, activity modification, a stretching program, shoe change, icing, and the use of an anti-inflammatory medication will usually promote healing and the ability to return to sports. The Achilles tendon should never be injected with cortisone, as rupture due to weakening can occur.

Sever's Disease

Sever's disease is a pre-skeletal maturity condition resulting from inflammation of the calcaneal (heel bone) growth plate near where the Achilles tendon attaches. The treatment is similar to Achilles' tendonitis, with the addition of a heel pad or heel cup. Occasionally this condition will plague a youngster off and on for 2­3 years until the growth plate closes. Casting to completely immobilize the ankle joint may be required.

Plantar Fasciitis

Plantar fasciitis is an inflammation of the plantar (sole of foot) fascia (a tough band of ligament-type tissue that runs along the bottom of the foot). Again, treatment is directed at relieving inflammation and gently stretching the involved tissues. Arch supports also help here to support the foot and decrease pain. While injection is occasionally indicated in the adult, it is typically not done in the younger population.

Stress fractures

Stress fractures are sustained as a result of repeated "micro trauma." A sudden change in training intensity is the classic cause of these injuries that typically involve the metatarsals (the bones in the mid-part of the foot). Stopping the activity that is causing the problem and casting are the mainstays of treatment. If the activity continues prior to healing, these micro fractures can become "real fractures".

Please contact Dr. Vail for an evaluation of your child's feet - especially if you notice any of the problems mentioned above. Prevention is the key to helping your child to develop properly.


Tuesday, November 10, 2009

Have You Checked Out Our Store?

Our On-Line Store is available for you 27/7/365 to meet any and all over the counter foot care products you may need. Click here to go directly to our store.

Foot care products are not just for adults! Here is one example of several products that are available for children, too:

Arch Angels Childrens Comfort Insoles

Doctor Designed Children’s Insoles (prefabricated orthotics) that comfortably fit in your child's shoes.

Maintain children’s feet in a neutral position.
Stabilize the feet and ankles.
Support the developing arch.
Arch Angels insoles (prefabricated pediatric orthotics) help ensure proper arch and foot development.
Made of comfortable, semi-flexible materials.

Use To Treat Children's:
Flat feet
Arch and heel pain
Feet that easily tire

Click here for more information about this product.

Developmental Disorders of the Young Foot

Flatfoot: Flatfeet are very common and typically genetic (inherited) in nature. It is caused by lax ligaments and/or tendons in the foot. The most common childhood flatfoot is supple, not stiff, and usually not painful. An additional underlying cause for a stiff flatfoot must be sought. Shoe wear has not been shown to promote arch development. An arch is usually present on standing by age 5. Arch supports (orthotics) are indicated for painful, supple feet and for patients with additional symptoms related to the feet (certain gait, knee, and back disorders). Arch supports are also indicated for those who wear out shoes extremely quickly. Surgery can tighten the ligaments or tendons but is reserved for the most severe flat feet.

In-toeing: In-toeing ("pigeon-toed") is typically not related to the feet but to lower extremity rotation. Tibial (shin bone) torsion (twist) is the most common cause of in-toeing in children aged 1­2. Femoral (thigh bone) torsion is the usual culprit in children aged 3-15. Bracing is controversial for tibial torsion, and fully ineffective for the femur. Surgery is performed only on asymmetric limbs or those with debilitating torsional abnormalities

Knock-knees: Knock-knees are typical in children aged 3-7. Knock-knees come after bowlegs and usually improve by age 11. Bracing is rarely required as resolution is typically dramatic. Surgery is rarely required.

Bowlegs: Bowlegs are typical in infants to age 12­14 months, and may be normal to age 2. Most bowlegs are symmetric, stable, and spontaneously resolve. Bracing has shown benefit to age 3­4. Surgery is most often indicated for those with an abnormality of the growth plate, a condition known as Blount's disease.

Please contact Dr. Vail for an evaluation of your child's feet - especially if you notice any of the problems mentioned above. Prevention is the key to helping your child to develop properly.


Thursday, November 5, 2009

How Socks Make The Feet

Sometimes kids do not like to wear socks: Either because it is fashionable not to do so or they simply would rather have their feet as least restricted as possible throughout the day. However, click here for an article from The American Academy of Podiatric Sports Medicine that details why it is important for everyone to wear socks.

Tuesday, November 3, 2009

Congenital Disorders

Disorders of the foot and ankle are a common cause for orthopedic referral in infant, pediatric, and adolescent patients. The spectrum of problems is wide: While most, fortunately, are not serious, some of the congenital abnormalities do require significant operative intervention and a prolonged period of treatment. Even many of the less serious problems are a source of major irritation to patients because they often put limitations on the routine activities of daily living.

The following are common foot and ankle congenital disorders:

Metatarsus adductus: Metatarsus adductus is a common congenital (present at birth) foot abnormality and is caused by a persistence of fetal positioning. It is one of the several congenital abnormalities known as a "packaging problem." "Metatarsus adductus" is a frightening sounding term but means simply that the metatarsals (the long bones in the mid-portion of the foot) are adducted, or angled toward the midline. As with any medical condition, metatarsus adductus can run the gamut from mild to severe. While one classification defines the degree of metatarsus adductus based on the amount of curvature, a better classification relies on flexibility. Feet are very supple and typically require no treatment. Those feet that are least supple require manipulation and stretching and the use of reverse last shoes, or perhaps a short period of corrective casting. Without treatment, most feet do spontaneously improve by age 3. After age 4, surgery may be considered to correct the residual deformity.

Clubfoot: Clubfoot is a more serious disorder that is not related to the intrauterine environment, but to a growth abnormality that can be strongly influenced by inheritance. The clubfoot is hooked like the adducted foot, but has true structural abnormalities that cause it to roll inward and point downward. Untreated, this results in a major disability. Treatment begins with casting; in about 40% of cases, minor surgical intervention is necessary for complete correction.

Congenital vertical talus: Congenital vertical talus is a fairly rare but serious condition. The position of the foot is a classic "rocker bottom." It must be differentiated from a hyper flexible foot, and if stiff, a cast is minimally useful and surgery is required.


If you notice your child is having any problems with her or her feet, please call Dr. Vail. He is here to help your child's feet be as healthy as can be.


Happy Feet...

Happy Feet...

= Happy Kids...

= Happy Kids...

= Happy Family!

= Happy Family!