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Orthopedics/16 month old with right toe issue


My daughter's right toe has stuck in towards her left foot since birth.  Our pediatrician had always said it would correct itself but has paid very little attention to it.  Over Thanksgiving my cousin who is a speech path. Watched my daughter play.  She felt strongly that I should seek help through NC's CDSA program (early intervention).  I self-referred and we had an evaluation December 10th.

Here is some background information: she started walking at 9.5 months, she will not keep shoes on and cries if we insist they stay on, she's been walking for 6 months and still falls frequently.  When she walks you notice that her right big toe turns in towards the left foot.

During the evaluation, we had our program manager with us the entire time, as I suspected, she did not qualify for services because she is not delayed.  However I did exactly as I had intended because I grabbed the PM and evaluation coordinator's attention so much that they had a PT drive in to look at her.  During the morning the evaluation took place on a room with carpet (we have hard wood) but the carpet made what she did with her foot even more noticeable.  She was noted as having her right big toe turn in.  She curved her toes as if she was grabbing the carpet, it looked as if her walking was making her right foot turn over and the left the other way.  I really do a poor job of describing it because I've never seen anything like it.

When the PT evaluated her, the program manager thought for sure she would override the non-qualify, however the PT was baffled at what the issue was.  She evaluated her for about 30 minutes.  She believes it is a hallux varus but doesn't know what is causing it.  She called the pediatric orthopedic surgeon at the children's hospital while we sat there.

So we left with a referral to see a surgeon on January 9 and being told they believe it's the big toe but she's never seen anything like it.  

Now I should say that our daughter's foot doesn't look deformed or like some freak Guinness Book of World Records type thing.  It looks like her big toe turns in.  She falls frequently when walking, she won't wear shoes and cries if we try and make her.  She definitely walks as if there is something going on.

I know you can't diagnose her over email but I would just look some information on anything you've ever seen that is similar?  What questions should we be asking at the appointment?  If surgery is the only option, how do we find one that has performed it before etc.?  

I can't find much about the hallux varus in children only as a side effect of bunion surgery.

Any help will be appreciated.

Dear Jessica,
This Chicago Podiatrist located in West Loop 60661,Roscoe Village 60618,Elmhurst 60126 & Bartlett 60103 says...
For your daughter's Right toe......
Go see an orthopedic surgeon who does pediatric foot surgery. Don't be afraid to ask about their training & how many cases they have done. The doctor should be empathic & make you feel comfortable. If you are not happy with the consult-seek another at a Children's Hospital-or Shriner's Hospital. There is a doctor in Chicago (Edwin Harris, DPM) who is very experienced  in these kinds of cases. Depending on what you hear-you probably want 2 experts to agree on the condition & treatment. You may wish to call Dr Harris & see if he can give a recommend in your location. There  be should no hurry in any possible surgical correction of your daughter's foot-and so take your time to feel comfortable with any recommendation. The x-rays taken should be weight bearing-to give the most info. Sometimes some issues may be resolved with what is know as serial casting-applying casts to gently manipulate the foot into a better position. If they offer non-weight bearing x-rays-decline. Since she will need weight bearing x-rays-avoid extra exposure.
Hope This Helps!
Good Luck!
The podiatrists of are specialists in foot & ankle pain.
We are located in Chicago & Elmhurst

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661

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Dr George Tsatsos


All questions related to orthopedics of the Lower Extremities-with a specialization in Foot & Ankle Orthopedics & Surgery-Adults & Children Sports Medicine questions of the lower extremities-including runner's injuries. Second Opinion specialist in Foot and Ankle problems including fractures and revision surgery. All questions relating to foot and ankle problems in Children, Sports medicine of the foot and ankle Runner's and walking problems


Board Certified in Surgery & Orthopedics of the Foot & Ankle. PRIVATE PRACTICES: Ankle N Foot, 2220 W Belmont Ave., Chgo., IL 60618 since 1979 Ankle & Foot Center of Elmhurst, 401 N.York Rd., Elmhurst, IL, 60126, since 1989. Physicians Suites, Bethany Hospital, 3435 W. Van Buren, Chgo., Il, 60624, since1980. HOSPITAL & SURGICAL AFFILIATIONS: Bethany Hospital, 3435 W. Van Buren, Chgo., Il.- Podiatry staff since 1979 Glen Oaks Medical Center, 701 Winthrop, Glen Dale Hts, IL – Podiatry staff since 1997. Elmhurst Medsurge, 401 N. York Rd., Elmhurst, IL, 60126, since 1999 Resurrection Health Care Surgery Center, 3101 N. Harlem Ave., Chicago, IL, since 1999 Chicago Neurologic & Orthopedic Hospital, 4501 N. Winchester Ave., Chicago, IL, since 2008 Organizations

Member American & Illinois Podiatric Medical Association Member of the National & Midwest Academy of Ambulatory Foot Surgery. Member of American College of Sports Medicine. Member of American Medical Athletic Association. Member of Chicago Metropolitan Ski Council.

Prolotherapy in the Treatment of Foot Problems Clinical Correspondence, June 2002. Vol 92- no. 6 Journal of the American Podiatric Medical Association. Paper on Treatment of Delta-Phalanx of the Foot – submitted for publication to Journal of Foot and Ankle Surgery & for Fellowship of ACPPS., September, 1998 Sports Medicine Consultant for the book-Triathlon 101 Essentials for Multisport Success by John Mora – 1999 ISBN 0-88011-811-3 Windy City Sports – October 1996 Marathon Issue “Keeping Your Feet Happy” American Running & Fitness Association, Clinic Advisor & Lifetime Member – Editorial Staff since 1990.

Fellow-American College of Foot & Ankle Orthopedists, since 1991. Fellow-Academy of Ambulatory Foot Surgery, since 1980. Fellow- American Institute of Foot Medicine , since 1987. Fellow-American College of Foot & Ankle Pediatrics, since 1998. Certified in Laser Surgery- by Wenske Laser Center, Ravenswood Hospital, 1991. Certified in Foot and Ankle Arthroscopy – by Doctor’s Hospital, 1991. Certified Preceptorship Director-Scholl College of Podiatry 1993-2006 Board Certified in Foot & Ankle Surgery-A.B.M.S.P., since 1987. Recertified 8/08 till 3/31/2012 Board Certified in Podiatric Foot & Ankle Orthopedics-A.B.P.O.P.P.M., 1991. Recertified 10/2003 till 12/2013 Board Certified in Pain Management-A.A.P.M., since 1990.-retired Clinical Instructor – Department of Medicine at Rosalind Franklin University 10/2007 until present

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