Question
My daughter's right toe has stuck in towards her left foot since birth.  Our pediatrician had always said it would correct itself but has paid very little attention to it.  Over Thanksgiving my cousin who is a speech path. Watched my daughter play.  She felt strongly that I should seek help through NC's CDSA program (early intervention).  I self-referred and we had an evaluation December 10th.

Here is some background information: she started walking at 9.5 months, she will not keep shoes on and cries if we insist they stay on, she's been walking for 6 months and still falls frequently.  When she walks you notice that her right big toe turns in towards the left foot.

During the evaluation, we had our program manager with us the entire time, as I suspected, she did not qualify for services because she is not delayed.  However I did exactly as I had intended because I grabbed the PM and evaluation coordinator's attention so much that they had a PT drive in to look at her.  During the morning the evaluation took place on a room with carpet (we have hard wood) but the carpet made what she did with her foot even more noticeable.  She was noted as having her right big toe turn in.  She curved her toes as if she was grabbing the carpet, it looked as if her walking was making her right foot turn over and the left the other way.  I really do a poor job of describing it because I've never seen anything like it.

When the PT evaluated her, the program manager thought for sure she would override the non-qualify, however the PT was baffled at what the issue was.  She evaluated her for about 30 minutes.  She believes it is a hallux varus but doesn't know what is causing it.  She called the pediatric orthopedic surgeon at the children's hospital while we sat there.

So we left with a referral to see a surgeon on January 9 and being told they believe it's the big toe but she's never seen anything like it.  

Now I should say that our daughter's foot doesn't look deformed or like some freak Guinness Book of World Records type thing.  It looks like her big toe turns in.  She falls frequently when walking, she won't wear shoes and cries if we try and make her.  She definitely walks as if there is something going on.

I know you can't diagnose her over email but I would just look some information on anything you've ever seen that is similar?  What questions should we be asking at the appointment?  If surgery is the only option, how do we find one that has performed it before etc.?  

I can't find much about the hallux varus in children only as a side effect of bunion surgery.

Any help will be appreciated.

Answer
Dear Jessica,
This Chicago Podiatrist located in West Loop 60661,Roscoe Village 60618,Elmhurst 60126 & Bartlett 60103 says...
For your daughter's Right toe......
Go see an orthopedic surgeon who does pediatric foot surgery. Don't be afraid to ask about their training & how many cases they have done. The doctor should be empathic & make you feel comfortable. If you are not happy with the consult-seek another at a Children's Hospital-or Shriner's Hospital. There is a doctor in Chicago (Edwin Harris, DPM) who is very experienced  in these kinds of cases. Depending on what you hear-you probably want 2 experts to agree on the condition & treatment. You may wish to call Dr Harris & see if he can give a recommend in your location. There  be should no hurry in any possible surgical correction of your daughter's foot-and so take your time to feel comfortable with any recommendation. The x-rays taken should be weight bearing-to give the most info. Sometimes some issues may be resolved with what is know as serial casting-applying casts to gently manipulate the foot into a better position. If they offer non-weight bearing x-rays-decline. Since she will need weight bearing x-rays-avoid extra exposure.
Hope This Helps!
and
Good Luck!
The podiatrists of AnkleNFootCenters.com are specialists in foot & ankle pain.
We are located in Chicago & Elmhurst

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661


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