CME OnDemand 2025: Management of Adolescent Hindfoot Deformities-Management of Adolescent Pediatric Deformities

Video Transcription

Video Summary

The webinar "Management of Adolescent Hindfoot Deformities" features orthopedic experts discussing updated approaches to treating adolescent flatfoot, cavovarus deformities, and clubfoot sequelae. Dr. Emily Kidambi outlines that flexible flatfoot is common in young children and often improves with age, but persistent cases with Achilles contracture (Aquinas) and hindfoot valgus may require intervention. Conservative management includes physical therapy targeting posterior tibialis strengthening, Achilles stretching, weight management, and supportive shoes. Surgical options include osteotomies like the Evans calcaneal lengthening combined with medial cuneiform or cuboid osteotomies for realignment, and calcaneal stop arthroereisis with screw insertion for younger or flexible cases, often preceded by a gastrocnemius recession. Successful treatment balances correction with preserving foot flexibility to avoid stiffness and pain.<br /><br />Dr. Anthony Riccio presents an algorithmic approach to cavovarus deformities often seen in neuropathic conditions. He emphasizes the importance of comprehensive soft tissue balancing before considering osteotomies or arthrodesis, especially in children, to preserve function and avoid premature joint degeneration. Tendon transfers, Achilles lengthenings, and plantar fascia releases are key, often staged with minimal bony procedures or gradual correction via external fixation for severe deformities.<br /><br />Dr. Jacob Zeid reviews clubfoot deformity management, highlighting Ponseti casting as the current gold standard and discussing common residual deformities like recurrent cavus-varus, overcorrection valgus, and dorsal bunions. Treatment principles include addressing the underlying tendon imbalances, cautious use of osteotomies, and avoiding fusions when possible to maintain foot function.<br /><br />Overall, management of adolescent hindfoot deformities requires individualized treatment plans focusing on restoring a painless, functional foot, prioritizing soft tissue correction, and carefully selecting surgical procedures based on deformity severity and patient age.

Keywords

adolescent hindfoot deformities

flatfoot treatment

cavovarus deformities

clubfoot sequelae

Achilles contracture

osteotomies

arthroereisis

soft tissue balancing

Ponseti casting

tendon transfers