Can anyone help me with this? "positional deformity of the foot"

[tweetyfish]

I'm really hoping someone can help as i'm really worried, and i've just chased up DD's physio and i'v been told it will be 3 more weeks at least.

Basically DD (15 months) has always held out her foot at a funny angle, up and out as it were. When she stands, she has the part between the sole of her foot and that little bone on the inside of your ankle on the floor, her toes are splayed out but don't actually touch the floor (sorry, i hope i'm making sense, it's a nightmare to explain!) I first queried it with my HV when she was 7 months old but it took them until late january for a paediatrician to see her.

She has said there's defianlty a problem and that she has quite a severe positional deformity of the foot, and referred her to the physio and surgeon. She told us that she may need a splint, but not much else on how to help her. She is now trying to walk (she can't, she only learned how to stand on her foot 4/5 months back) and i'm petrified that she is doing more damage than good, and that when the physio finally get to see her, it'll have worsened.

I was wondering if anyone else had come accross this, is there is anything i can do to help her, like get her "proper" shoes that support her ankle more.... I'm really hoping that someone does know something because the thought of knowing that there is a problem buthaving to wait another 3 weeks before she gets treatment is tearing me apart. It's so obvious that she wants to walk but can't.

[Blu]

Tweetyfish - has the paediatrician just refrred you for physio, or also to an orthopaedic consultant? Or orthotics?

Firstly - don't worry - in the longer - and probably shorter -term your dd will be fine. Splints are not very frightening - they tend to be made of nice patterned plastic, and fit down the calf and cradle the foot, but with the front open. My DS learned to walk while wearing a splint, at about 15 months.

Going by what our orthopaedic cinsultant has always said, i would have thought they would want to start whatever procedures will help your DD now, as she is starting to walk. The other thing that might happen is that she is referred for piedro boots - special support footwear - but again, they are quite funky looking and come in some nice colours.

Possibly she will need some v small surgery, to release tendons or something - DS has a much more complicated condition than your DD, and he was fine after surgery.

Chivvy for faster appointments? they do sem to have left it a v long time before getting you some expert help.

[Blu]

Tweetyfish - where in the country are you? I wonder if your GP can help getting you an appointment faster - or a second opinion from an orthopaedic consultant

[Dinosaur]

DS2 was born with talipes (clubfoot) of both feet. He had a lot of treatment when he was a baby and toddler and his feet are good now.

Try not to worry too much. DS2 has been treated by a marvellous orthopaedic consultant in Sunderland - can give you details if you can get there and want a second opinion.

[tweetyfish]

Thanks for answering so quickly blu! Yes they have left it late, I'm convienced the HV forgot the first time i asked her to do something . She has been referred to both the physiotherapist and the orthapaedic surgeon... not sure what orthotics is.

I had visions of splits being the things that you have pins in you leg and a cage outside.... But what you descibe isn't scary at all!

Can you really influence waiting lists?!

[tissy]

tweetyfish- your dd's foot deformity may be correctible with casting or may need a wee splint or even an operation, but she will not be doing any permanent harm by standing on it and trying to walk. If you're only waiting 3 weeks to see the physio/ orthopaedic surgeon, nothing terrible will happen in that time. Be patient and let her do what she wants to do.

[tweetyfish]

I'm in Bromley - bottom of london or top of kent! So sunderland might be a way!

Do you think it might be worth getting stronger boots in the meantime? My mum keeps saying that's what she needs, but i just don't know!

[tweetyfish]

thanks tissy I've caught her a couple of times moving off as if she could walk and at the last minute realising that she's better crawl!

[tissy]

A slint is a thin plastic "shell" that is worn inside the shoe to hold the foot in a better position. Please do NOT let yourself get all worked up about the "maybes" at this stage. If the physio thinks there is amajor problem with the foot, it is likely that he/ she will have a "fasttrack" route to the orthopaedic surgeon.

[tissy]

Don't bother getting boots at the moment- she will walk when she's ready and not before. You don't need to go all the way to Sunderland there are plenty of decent paediatric orthopaedic surgeons on London- blu could name one of them!

[tweetyfish]

Thanks guys, it's just so easy to get yourself worked up when you know there's something wrong but nothing else is happening.

How long do they wear splints for? Are they painful?

[tissy]

if they fit properly splints aren't painful at all, but as for how long...depends!

[Blu]

Yes, sorry, Tweetyfish, i was pobably being a bit alarmist suggesting you make a fuss about waiting times now!

'Orthotics' is the department that deals with splints, piedro boots, etc. But Physio often make splints, too, I think. DS's first splint was done in the physio dept, anyway.

I do know that people from Bromley get referred to the paediatric orthopaedic surgeon we see, in S London, so CAT me if you would like more details .

If she is given a splint, it is possible that she will have one for day and one for night. DS has never rebelled against his! He wore a splint for walking for about a year, I think, and then 'graduated' to Piedro boots...but I'm sure it differs in all cases.

And really, don't worry. DS's walking was delayed because of all his treatment etc, but even with bones missing and a short leg, he is as sprightly as could be!

[tweetyfish]

wow that's great blu! I'm always in awe of the way that children just get on with it, whilst us mums worry about it all!

[Blu]

Oh yes! The pain is all ours!
Let us know how she gets on, and do CAT me if you want to talk specific details about hospitals / consultants.

[tweetyfish]

Thanks blu! I have just rung the Hospital where she is being referred to, and apparently both surgeon and his secretary have been away on their holidays (lucky them!) but are back on wednesday so hopefully things will start moving then! I think he's quite good, plus I used to clean all his surical instruments when i worked at the sterile services so i'd quite like to put a face to the messy sets we used to get back Thank you very much for the offer though

[ck1]

There's a private orthotics clinic in Wimbledon (orthotics are usually NHS, with corrresponding long wait list). I don't know if they have dealt with this, or can deal with this, but may be worth a call to find out:

www.technologyinmotion.com/


Have just looked them up and they also have a dedicated foot website:

www.precisionfeet.co.uk/

[tweetyfish]

Just a quick update: DD was seen by the physio and othotics dept, and was kitted out in a beautiful pair of Piedro boots. That was a week ago, and she is now walking the length and breadth of the living room all by herself!

I cannot believe the difference the boots have made, and how quickly she has made progress.

Thank you all again for calming me down and out of my panic!