Orthotic Management of Valgus Foot Deformity in Children with Spina Bifida
JOAN FERGUSON, MCSP*, GREG BELBIN, CO(C),AND NORRIS CARROLL, MD, FRCS(C)Toronto, Ontario
A case presentation demonstrates the use of a polypropylene ankle-foot orthosis for control of valgus feet in a child with spina bifida. Progressive valgus deformity leads to an increasingly unstable and energy-consuming gait, with flexion at the hips and knees and the possibility of tissue trauma. By positioning the feet in a corrected or overcorrected position using well-designed AFOs, the progressive nature of the deformity can be controlled. Increased stability of the feet leads to extension at the hips and knees and to less effort being required in ambulation.
Parents and child are educated in the care of skin and monitoring the fit of the AFO and, with good compliance, tissue trauma problems can be eliminated. Criteria for prescription of the orthosis, positioning for casting, materials, and methods of fabrication and fittings, were discussed, as was care of the skin and the orthopedic and functional benefits to the child.
*Hugh MacMillan Medical Centre, 350 Rumsey Road, Toronto, Ontario, Canada M4G 1R8