Knee & Foot Deformities
The deformity can either be because of old neglected trauma or a sequel of infection in the past. It requires a very individual approach to the case as per the patient’s symptoms and needs. Sometimes deformities around joints can be treated with replacement alone and in some cases, it may require additional fixation as well.
Signs and symptoms
The most prominent symptom of knee and foot deformities is a separation of a person’s ankles when their knees are positioned together. Other symptoms, including pain, are often a result of the gait (manner of walking) adopted by people with knee and foot deformities. These symptoms may include
● knee or hip pain
● foot or ankle pain
● feet not touching while standing with knees together
● stiff or sore joints
● a limp while walking
● reduced range of motion in hips
● difficulty walking or running
● knee instability
● progressive knee arthritis in adults
● patients or parents may be unhappy with the aesthetics
Diagnosis
An orthopedic specialist will review the patient’s medical and family history, any pre-existing conditions, and current health. They will also do a physical examination of the legs and gait. Standing alignment X-ray or EOS images will help confirm the diagnosis. These are radiological images of the leg from the hip down to the ankle, which help the doctor locate the exact location and mechanical axis of the deformity.
Treatment
The following treatment program was followed for "early" patients:
(1) non-weight bearing, utilizing either crutches or a wheelchair;
(2) isometric exercise for the quadriceps and posterior tibial muscles;
(3) range-of motion exercise for all joints;
(4) stretching of the peroneal muscles to gain range of motion in an inversion of the foot; and
(5) shoes with solid medial counter and custom-made foot supports to prevent pronation of the foot with weight bearing. Unrestricted walking was permitted when good muscular strength was achieved.
The treatment program for patients with "late" abnormality included:
(1) isometric exercise {vide supra)
(2) range-of-motion exercise
(3) stretching of the peroneal muscles
(4) foot supports; and
(5) long-leg brace to provide stability to the knee during walking.
When flexion contractures were present, a posterior night splint for the leg was used to correct the flexion deformity.
Conditions Treated
- Autism Spectrum Disorder (ASD)
- Attention Deficit / Hyperactive Disorder (ADHD)
- Down’s Syndrome
- Dyslexia
- Cerebral Palsy
- Sensory Process Disorders
- Learning Disability
- Intellectual Disability
- Speech / Language Delay
- Neuro / Motor Developmental Delay
- Global Developmental Delay
- Muscular Dystrophy
- Knee & Foot Deformities
- Generalized Epilepsy / Seizures
- Genetic Syndromes
- Traumatic Brain Injury
- Hypoxic Ischemic Encephalopathy (HIE)
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