Children's Foot Deformity Correction in Sharjah

What is children's foot deformity correction?

Children's foot deformity correction is treatment that moves a child's foot, step by step, from a twisted or stiff shape into a position that lets the child stand flat and walk comfortably. It works with growth: a baby's foot bones are still mostly soft cartilage, and the tight tendons and ligaments around them stretch well in the first months of life. That is why treatment for clubfoot usually starts in early infancy, and why most of the correction comes from casts and a brace rather than from an operation.

The most widely used technique for clubfoot is the Ponseti method, in which the foot is stretched by hand and held in a new plaster cast at each visit, so that the foot turns outwards and upwards a little more each time. At Dar Al Kamal Hospital, Sharjah, children's foot deformity correction is carried out by the orthopedic team, working with the Pediatrics department so that your child's general health and development are looked after together.

Who needs it

Foot deformity correction is for children whose foot shape is fixed or stiff, rather than a flexible stage of growth. The conditions treated include:

• Clubfoot (talipes equinovarus): the foot points down and turns in at birth, sometimes on both sides. It is often seen on the pregnancy scan, which gives parents time to plan treatment before delivery.
• Rigid or painful flat foot in an older child, for example when two small foot bones have grown joined together (tarsal coalition), which tends to show up as ankle sprains or aching in the early teens.
• Vertical talus, a rare stiff flat foot present at birth, where the sole curves outwards like the base of a rocking chair.
• Curved or stiff forefoot (metatarsus adductus) that stays curved after stretching exercises.
• High-arched foot (cavus foot), which in a child is also checked for an underlying nerve or muscle cause.

Many foot shapes that worry parents, such as flexible flat feet and mild in-toeing, are normal and are covered on the pediatric orthopedics page. For a stiff deformity, the choice is between casting and bracing alone, casting followed by a small procedure, or surgery for an older child whose foot has already set. The decision rests on your child's age, how stiff the foot is, and what the X-rays show, and the surgeon explains each option before you decide.

What happens

For clubfoot, the first visit is a full examination and a scoring of how stiff each part of the foot is. At each casting visit, the surgeon gently stretches the foot into a slightly better position and applies a plaster cast from the toes to the upper thigh, with the knee bent, which keeps the correction in place. The cast is changed at regular visits, and the foot turns a little further each time.

Most babies then need a small procedure called a tenotomy, in which the tight Achilles tendon at the back of the heel is released through a tiny cut, so that the foot can bend upwards. A final cast lets the tendon heal in its new, longer position. After that, your baby wears a foot abduction brace: two shoes joined by a bar, which holds the feet turned outwards. The brace is worn almost all day at first, then during sleep and naps through the early childhood years, as it keeps the foot in its corrected shape.

For older children, or feet that have set, surgery may lengthen or move a tendon, release tight tissue, separate joined bones, or reshape a bone with an osteotomy. These operations take place under general anaesthesia, with a cast afterwards while the foot heals.

Preparing for it

For casting visits, dress your baby in loose clothes that fit over a long leg cast, and bring a feed, since a baby who is feeding stays relaxed while the cast sets. Bring your baby's health record, the pregnancy scan report if clubfoot was seen before birth, and a list of any questions.

Before surgery, the team gives you clear fasting instructions for your child and explains the anaesthetic. Tell the team about any recent cough, cold or fever. If surgery is planned around Ramadan or a school term, raise it early so the timing works for your family.

Afterwards

Check the toes several times a day: they should be pink, warm and able to wiggle. Keep the cast dry and clean, change nappies often, and in the Sharjah heat keep your baby in a cool room with light clothing, as sweat under plaster irritates the skin. The brace stage is where the correction is kept, so wearing it as advised is the most important part of the whole treatment. The team shows you how to fit the shoes and check the skin.

Dar Al Kamal Hospital's own pediatric physiotherapy team can guide stretching, walking and strengthening as your child grows, and regular clinic reviews continue through childhood.

Contact the hospital the same day if the cast slips down, cracks, gets wet or smells, or if the skin at the brace or cast edges is red or broken. **Go to the emergency department straight away if the toes turn pale, blue or cold, if swelling increases, or if your child has a fever or has pain that does not settle.**

Cost and insurance

Most UAE health insurance plans cover consultation, casting and surgery for a child's foot deformity when it is medically needed, and surgery usually requires pre-approval. The foot abduction brace and special shoes are sometimes assessed separately or covered up to a limit, so check this early, as your child will need new sizes while growing. Dar Al Kamal Hospital, Sharjah can help you confirm your cover on 06 599 7777.