Posted by: Tracy | 2009/05/15

My Daughters Club Foot

Hi. My daughter was born with shingles and has since suffered with one leg. Its 3 cm shorter and the foot is sort of clubbed, its also 3 sizes smaller than the other. She wears built up shoes but still battles because her achillies tendon is completely tight and there is not alot of movement. The Orthopedic that we saw in PMB said he wouldnt like to operate because she also has neuropathy in the foot. Fair enough but she is 16 years old now and cant bear to walk like she does (because of the tendon) and she doesnt want to wear takkies anymore. Is the another route we can take to try help her out. She is also suffering terrible hip and back pain because of the limp even with the built up shoes. Im desperate for advise.

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Our expert says:
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Dear Tracy

This is a complicated situation because of the practical problems in trying to adjust for a considerable limb length inequality. Its hard to comment accurately without having seen your daughter's foot but I have several patients who have a similar condition.
Firstly the limb length difference: A built-up shoe should eliminate the hip and back pain so if she is still getting it, there is probably not enough correction. I would have an x-ray of the legs done in stance from the waist down and determine exactly what the difference in leg length is. It is important to eliminate the hip and back pain because this will cause ongoing problems. There are several ways to modify shoes to accomodate the difference, both inside and under the sole of the shoe, possibly a combination of both.
This becomes complicated because of the tight achilles tendon which is quite common with this condition. I suggest that you find a good physio that can work on the tendon. Its unlikely that there will be complete correction but you can make a big difference in achilles tendon length.
I also find that there is a tendency for the foot itself to be slightly deformed, which alters the way it functions when walking. This would also need to taken into account.
I have in similar situations made a prescription insole that supports the feet correctly, taking the achilles and foot shape into account. This would need to be able to fit into a built-up shoe. Unfortunatly this type of insole does limit the shoes that could be worn.
Hope this helps,

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