Pediatric Flat Feet – 9F

Pediatric flat feet are some of the most gratifying types of cases….

This 9 yo female presented with bad flat feet that hurt her everyday for 2-3 years. She had failed inserts and PT. She was told she would have to wait until she was skeletally mature to have correction.

First thing noticed on exam was the rigidity to her hindfoot. Lateral plain film showed “anteater nose sign”. We ordered MRI to confirm coalition and observe adjacent joints.

We performed coalition resection, Evans, and Cotton in that order. We prefer to soak allograft wedges in BMAC to hasten incorporation. Surprisingly, TAL was not needed.
Small hand plate was used for Evans graft, and small staple for Cotton. This young lady had particularly tiny feet.

Post-op films are at 4 months with total graft incorporation.

Range of motion is now excellent at hindfoot….It was neat to see her Mom’s tears of joy after surgery.