Pediatric foot problems require special care and attention by a board certified foot specialist. Fortunately, Dr. Bregman is the only Pediatric fellowship trained Podiatrist in Nevada. Dr. Bregman is the primary source for referrals from some of the biggest Pediatric practices in Las Vegas.
We treat simple problems, such as ingrown toenails and warts to the complex problems such as clubfeet, in-toeing, metatarsus adductus, severe flat feet, and other congenital deformities like toe walkers. Dr. Bregman has completed a pediatric fellowship as part of his training and has performed hundreds of pediatric reconstruction procedures.
Many times orthotics can be used to treat some minor problems however sometimes surgery is indicated, but Dr. Bregman utilizes the latest minimal invasive techniques for surgery with your child. We know that this can be a scary proposition for some parents as well as the child but we take great care in explaining things and making sure everyone is comfortable with the plan.
Some of the most common pediatric foot problems we see are:
In-toeing- when the feet turn inward which can have multiple causes. Femoral Anteversion or having tight anterior hip ligaments is one of the most common caused for the feet to turn inwards. Usually the child will sit in the reverse “W” position, as this is more comfortable for them. Often times PT will be ordered for this problem as well as orthotics. The feet will often hyper-pronate to compensate for the hips and this can lead to other problems.
Metatarsus Adductus- this is a “C” shaped foot where the metatarsal bones are pointing inward. In most cases we use orthotics for this but rarely surgery is needed to break all of the metatarsal bones in the foot to straighten them out.
Calcaneo-Valgus- this is a congenital flat foot and sometimes require surgery but can be treated with orthotics.
Heel Pain- Often caused by growth plate issues referred to Sever’s disease or calcaneal apophysitis.
Pes Valgus/Tibio-Talar instability- This is a flexible flat foot that often will need treatment. We try and use conservative therapy when possible and this usually involves orthotics but sometimes surgery is the best course for a permanent correction. Dr. Bregman is a HyProCure master surgeon and this newer procedure for treatment of this condition is dramatic and there is a very quick recovery in most cases. Often times parents will say “my child’s ankle is turning inward” the reality is that it is the talus that is the problem and this is what needs to be addressed and not the ankle.
Toe Walking- This is not uncommon and can be due to a tight Achilles or sometimes it is a developmental issue. It is okay up to age 2 but as the child gets older and it persists then it should be at least looked at by a specialist. If it is still happening after 5-6 years old then formal physical therapy and possible surgery may be indicated. Dr. Bregman has performed life-changing surgery for toe walkers and you can see them on his YouTube channel just look him up!
Warts- Caused by a virus that is usually picked up in the shower or by pools. Viruses are very hard to get rid of. About 50% or so will go away on their own but if present after 6 months or if they are painful they should be treated. They are contagious but not very contagious. We use topical acid therapy and sometimes we use oral medication as well to treat this problem. Sometimes surgery is needed to remove the painful wart(s) especially if deep. Laser treatment is also available. Treatment is usually done every two weeks until they are gone. The drier you can keep the feet the better.
People who have sweaty feet are more prone to warts.
Ingrown toenails- Nobody knows the exact cause but they are very painful. If an infection is present then the infection needs to be treated and then see a specialist to have a permanent solution for the problem. Often times we do a chemical destruction of the offending nail plate. This involves removing a small portion of the nail and destroying the root with a chemical such as Phenol. This has a high success rate and is usually not painful. Once your child has this condition once the pediatrician should refer you to Dr. Bregman for definitive treatment. Sometimes a bone tumor can be the cause of an ingrown nail so x-rays should be taken.