Treatment of Foot Disorders at John Hunter Children's Hospital

• Club Feet
• Congenital Talipes Equinovarus (CTEV)
• Flat feet
• Foot surgery
• Intoeing / pigeon toeing
• Posterior Medial Release
• Triple Arthrodesis
• Subtalar fusion
• Tarsal coalition
• Tendon transfer
• Tendon lengthening

 

Club Foot

Club foot, or Congenital Talipes Equinovarus (CTEV) is a common condition affecting up to 100,000 babies worldwide each year. At The John Hunter Children's Hospital children are treated for CTEV by the Ponseti method. This method has been shown over 50 years to reduce the pain and stiffness felt by patients, with club foot, through their life span.

Some useful resources can be found at:

• http://www.chw.edu.au/prof/services/clubfoot/
• http://www.steps-charity.org.uk/links/4-14-clubfoot_or_talipes.php
• http://www.steps-charity.org.uk/downloads/Clubfoot%20-%20Talipes.pdf (pdf 785K)

 

Foot Surgery

There are many reasons why your child may need foot surgery.

Below are examples of the most common 4 surgeries performed on children at John Hunter Children's Hospital: 

1. Posterior Medial Release - an operation to correct club foot (CTEV).  The surgery may be needed to release the ligaments and tendons that pull the foot out of its natural position.  A pin is also usually inserted to hold the foot in the correct position.  A plaster cast will be applied.
2. Triple Arthrodesis/Subtalar Fusion - an operation to stabilise the three joints within the ankle.  A subtalar fusion is one operation to stabilise one joint in the foot.  Either of these operations may be needed for patients with serious foot deformities.  Surgery consists of fusing/joining the joints using metal screws and grafting bone from other areas of the body.  A plaster cast below the knee is applied.
3. Tarsal Coalition - This condition occurs when the joints in the foot do not form correctly.  The foot is stiff, flat and deformed.  The foot movement is restricted and often causes pain.  Surgery is required.  The surgery is done to remove the bone causing the stiffness and a below knee plaster is applied.
4. Tendon transfer/lengthening - Soft tissue of the foot is made up of ligaments, tendons and muscles.  Surgery on the soft tissues corrects the foot deformities that do not contain bones.  Children with cerebral palsy, club feet and spina bifida often require this type of surgery.  A plaster cast is applied to hold the foot in the correct position.