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Sometimes, muscle forces and gravity work together to cause the foot to flex in the middle rather than at the ankle joint. We do our best to prevent this with bracing, but it is not always possible.
Lateral column lengthening surgery can help. It uses a bone graft to improve the shape of the foot. For the first six weeks after surgery, your child cannot be allowed to walk or put weight on the foot. The rest allows the bone to start healing before it has to handle weight and muscle forces.
The bone graft usually is from a cadaver, but other options include using your child’s own hipbone or factory-made bone.
Foot bones need to reach a level of maturity before the surgery can be performed. Your health care provider will make this decision.
Sometimes this surgery is paired with other procedures, such as tendon lengthening. Most often, the heel cord is lengthened, and one muscle that turns the foot out (peroneus brevis) may be lengthened if needed. If the surgery is localized to the foot and ankle, your child will be in a short leg cast.
After six weeks, the cast is replaced and your child is allowed to walk. With the second cast in place, your child should return to therapies.
Your health care provider will work with you on the follow-up treatment plan that is right for your child, based on factors unique to him or her.