Holding two fingers up in a V can have many meanings depending on the situation. It began during World War II as a victory sign for the Allies. Now, it can signify a win in competitive sports, peace in a hippie commune, or an insult in the UK or Australia—if you do it with your palm facing toward you. There is another use, this one in the delivery room at the hospital. It is a way for the pediatrician to test a newborn for certain foot abnormalities. Fortunately, even if your children’s feet have a problem at birth, many times it resolves on its own. If not, advances in treatment can have you holding up the V for victory after they are corrected.
Reconnoitering the Territory
Many foot problems can be determined right after birth, or even before birth with an ultrasound image. Simultaneous examination of both feet can show any differences in one or the other. The skin is examined for folds or taut places that could indicate certain deviations. The range of motion of various joints in the feet and legs is tested, as well as their flexibility, whether they are symmetrical, and if they lie in the right position. Finally, blood flow is checked using skin color and how quickly it returns to normal after an area is pressed.
Identifying the “Enemy”
There are several pediatric irregularities that can commonly be detected in the delivery room. Brief descriptions and treatment methods are listed here.
Metatarsus adductus (MTA) – With the V-finger test, the baby’s heel is placed at the juncture of the doctor’s index and middle finger, and the bottom of the foot is observed, to see if the metatarsal area seems bent toward the inside of the foot. Mild cases need only observation, and moderate ones can usually be corrected with some stretches during diaper changes. Only severe deviations may need manipulation and serial casting to correct the angle of the metatarsal bones.
Club foot – This is a congenital condition that causes the feet to point down and bend in at the toes and the soles of the feet to tilt up. The foot or heel may be smaller, and the Achilles tendon very tight. Whether the foot is still supple or quite rigid, it is treated with serial casting. If it is not corrected by six to nine months, surgery may be used to further straighten the foot and provide stability for walking.
Calcaneovalgus – An overstretched Achilles, tight anterior leg muscles, and rotation of the heel bone may cause one foot to turn inward. This condition also usually responds to stretching, splinting, special shoes, or serial casting, depending on how severe the abnormalities are. A related condition is congenital vertical talus, also called rocker bottom foot, in which the arch is almost reversed, causing a curved bottom foot, and the mid- and forefoot are lifted upward. This almost always requires a complicated surgery to correct.
Toe deformities – Included in this classification are polydactyly (extra toe or finger structures), syndactyly (webbed toes or fingers), and overlapping toes (one toe growing up over another). Surgery can remove extra digits or tissue between the toes, but overlapping toes can usually be treated with stretches and toe spacers.
Catching these abnormalities early is helpful, because any treatment needed can begin as soon as feasible and parents are alerted to monitor their child’s foot development.
Helping You to Victory
The team of podiatrists at Atlantic Foot & Ankle Associates stand ready to answer your questions and treat any foot problems you may detect in your children. Dr. James Rust, Dr. Andrew Green, Dr. Dennis McBroom, Dr. Sona Ramdath Jr., Dr. Laura Walton, and Dr. Hilaree Milliron are committed to promoting healthy feet. Call our office in Orange City at (386) 775-2281, or find the numbers for our other locations on the top of our website pages. We would be honored to have you trust us with your children’s feet!
Photo Credit: Sura Nualpradid via FreeDigitalPhotos.net