Bony foot correction procedure

Introduction

A bony foot correction is a procedure used to correct the foot's shape.

Your child may need a bony foot correction if they have issues with their feet, including:

• instability - rolling of the ankle
• poor alignment - foot pointing inwards or outwards rather than forward
• pain when walking
• pressure areas - areas on the foot where there is constant rubbing or pressure
• issues with using ankle foot orthoses (AFOs).

Bony foot correction procedures straighten the foot and reduce the amount of rubbing and pressure from AFOs, improving comfort and fit.

The lateral column lengthening of the foot is a common bony foot correction procedure. 

Your child's treatment team will assist you and provide you with information on how to prepare your child for the procedure.

It's important to take the following steps before your child has the bony foot correction procedure:

• ensure that your local therapists are aware of the upcoming surgery
• get in touch with your local physiotherapist or occupational therapist to go on their waitlist and inform them that your child is having the procedure
• inform your child's school about the procedure and let them know that your child may be off school for several weeks
• arrange time off for yourself around the surgery date and let your family and friends know so that they can provide support if required
• inform the hospital as soon as possible if your child becomes sick before the procedure date, as it may need to be postponed. 

Your child will be under general anaesthesia for the operation. This means they will be asleep and will not feel any pain.

In the bony foot correction procedure:

1. a cut is made in the foot, and the position of the bone is corrected
2. if a bone graft is needed, a cut is made near the hip, and a piece of bone is taken from the top of the pelvis
3. the extra piece of bone is inserted to straighten and stabilise the foot
4. the surgeon will insert surgical wires or plates and screws to hold the bone graft in place and the foot in the correct position.

If your child needs to have other soft tissue procedures, they can be done at the same time. These procedures can include lengthening tight muscles or tendons or moving them so that they work differently.

Your child must rest and keep their leg elevated for the first few days after the procedure.

Your child will have a plaster cast on their leg below the knee, which will typically remain in place for 6 to 9 weeks. During this time, they won't be able to bear or carry their body weight. They will need crutches, a walking frame, or a wheelchair to help with moving around. 

If surgical wires or K-wires were used during surgery, they will be taken out after six weeks. Plates and screws will stay in place for 1-2 years. 

After the K-wires are removed, your child will be fitted for an AFO to replace the plaster. 

Your child must wear the AFO at least 23 hours a day after the surgery. Your child may need to wear the AFO full-time for at least three months and longer while walking. Most children will need to wear AFOs longer to help the bones heal correctly and to support the new corrected foot position. 

If your child does not wear the AFO, the foot may return to its original shape.