Maryland's Health Matters - St. Joseph - Fall 2013 - (Page 6)

HAPPY FEET Options for painful feet are available at UM St. Joseph Medical Center’s Orthopaedic Institute I magine a young girl loving to dance but coming out of her classes limping from foot pain. Or a teenage basketball player who couldn’t jump effectively because of arch pain. Siblings Brie and Ryan Jadra shared an inherited trait, ﬂat feet, which made athletic activities almost excruciating. Each sibling had an extra foot bone that attached to the main bone, pulling the tendon and causing pain. “A lot of kids have a developmental ﬂat-foot abnormality—it’s just the way their feet developed,” explains Jeffrey Brodie, MD, orthopaedic surgeon with Towson Orthopaedic Associates. “Most of the time, a custom or offthe-shelf orthotic solves foot pain. Pediatric Jeffrey ﬂat feet can usually be Brodie, MD treated nonsurgically. It’s unusual to have two family members who need surgery.” TYPES AND TREATMENT FOR BONE DEFORMITIES There are two types of bone deformities that may require corrective surgery. The Jadra siblings had an accessory bone on the inside of their arches. The other type is a tarsal coalition in which two bones in the back of the foot are joined together. 6 MARYLAND’S HEALTH MATTERS “The surgery is fairly simple,” says Dr. Brodie, a highly experienced foot and ankle specialist. “I remove the extra bone and detach and reattach the tendon. A small screw is implanted under the ankle bones to provide support for the heel and to prevent the ankle from kicking out.” The screw is nonmetal and dissolves eventually. Return to full activity after surgery takes about six months, but for the Jadras, it was worth it. “Ryan now plays high school basketball and coaches a YMCA team. You’d never know he had any issues at all,” says his mom. Brie, who began dancing at age 3 and is now 12, says, “I wanted to have the surgery. I had trouble jumping and going up on my toes. My pain was only going to get worse, and my brother said the surgery was no big deal.” FLAT FEET IN ADULTS Flat feet can also develop in adults later in life, causing pain and difﬁculty walking. “Over time, the tendons in the ankle can stretch, or become weak or injured,” Dr. Brodie says. “They’re not supporting the arch anymore. The arch collapses, and the heel kicks out.” The Achilles tendon can become tight and shortened. “It happens more frequently in women than men, usually in the late 40s through late 60s. The cause is often years of wearing high heels that stretch and stress the ligaments and tendons.” The ﬁrst line of treatment is nonsurgical. Patients may need a walking boot for six weeks, followed by custom orthotics in their shoes. Comfortable, supportive shoes are necessary, and dress shoes can be worn occasionally, Dr. Brodie explains. “Surgery becomes a consideration when conservative treatment doesn’t work and pain interferes with daily activities.” There are two operations that can be done to restore the feet. The risks and beneﬁts need to be discussed with your surgeon, advises Dr. Brodie. For younger patients who are not overweight and still have joint mobility, Dr. Brodie breaks the heel, shifts it over, performs a tendon transfer to replace the torn tendon, and lengthens the Achilles tendon. “If that option is not possible, I fuse the joints in the back of the foot and do the Achilles lengthening. Patients continue to have the ability to move their ankle joints up and down.” Patients report that both surgeries are very successful. “They tell me that they can go to the mall and walk for hours. I’ve even had younger patients who are runners and can return to a moderate level of exercise,” Dr. Brodie says.  UM St. Joseph’s Towson Orthopaedic Associates has ﬁve locations. Find one near

Table of Contents for the Digital Edition of Maryland's Health Matters - St. Joseph - Fall 2013

Maryland's Health Matters - St. Joseph - Fall 2013
Contents
A Healthy Start
Family Ties
Happy Feet
A Winning Trial
At a Glance
Foundation Halls
News and Events

Maryland's Health Matters - St. Joseph - Fall 2013