The most common problems and when it is time to intervene

The most common problems and when it is time to intervene
Feet are so varied from a morphological and structural standpoint that, in reality, it is difficult to define what is and what is not a defect, whether or not it is right to intervene, and if so, when.
In our experience, evident structural deviations from what can be considered a normal morphotype are well tolerated and do not cause functional restrictions while other deviances, that may be less evident and at times difficult to expose, give rise to a functional hindrance and cause pain. In general terms, it is correct to say that what is superfluous should be removed.


Polydactylism, more commonly known as extra fingers or toes, must be treated by removing the fingers or toes that are superfluous. It is advisable to have this operation done before the child starts to stand upright, within his first year.

Congenital clubfoot

In many congenital deformities, that is those that exist from birth, and which through experience we know to be very resistant to treatment, such treatment must start right from the very first days of the baby's life. The clubfoot condition is to be found in 1/1000 newborn babies. As the term suggests, the foot is deformed like a club, and is hard and rigid like a stick. This condition requires immediate and intensive treatment in the form of massage and corrective plaster, starting from the baby's first days of life. It withstands corrective treatment and in most cases, needs to be operated towards 5-6 months. Throughout the period of growth, arch supports and braces must be applied.

In some cases, further operations are needed. This foot will remain smaller, the calf thinner, the ankle and foot fairly stiff. However, no pain will be felt and neither will the patient limp.

If well treated, recovery will be sufficient to allow the child to play and practise various types of sport, as well as being able to have an intense working life as an adult.

Pesplano valgus

Once more we have learnt that, in the course of the morpho-structural growth development of the bone structure, some originally dramatic cases, like knock knees, actually return to normal.

Other quite banal conditions become progressively worse and end up as serious defects.

We therefore believe that a real defect is one involving functional restrictions and pain.

In a foot with a pesplano valgus condition, for example, it is necessary to intervene only when serious functional restrictions appear, or if the child experiences pain to such an extent that it limits his play and sports activity. The objective is to recover well-being, and not necessarily a normal morphology and structure. This can be achieved with arch supports, suitable footwear and foot exercises that help recover a muscular equilibrium and satisfactory movements of the joints. In some very special cases, surgery may solve conditions that fail to respond to conservative treatments.


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