Secondary hindfoot valgus requires a medial displacement calcaneal sliding osteotomy. Knee Problems These are usually associated with quadriceps weakness which can be treated with hamstring release. Valgus deformities sometimes require iliotibial band release or late osteotomies Spine Problems Upper lumbar kyphosis and other congenital malformation, result from disorders of the spine due to lack of segmentation or formation. Kyphosis is a difficult problem The Lindseth Procedure involving resection of the kyphosis with local fusion is the most common treatment. If curves are 60 degrees the most effective treatment appears to be segmental luque sublaminar wiring with fixation to the pelvis or the front of the sacrum usually preceded by anterior release and fusion.
Infection is a problem due to frequent septicemia in patients and poor skin quality.
This is caused by prolonged unilateral hip contractures or scoliosis. It is relieved by custom seat cushions, and surgery, including spinal fusion, thoracolumbosacral orthosis or in more severe cases, pelvis osteotomies. These disorders are progressive involving muscle weakness. It is a noninflammatory, inherited disorder with several, separate classifications. This affects young boys only.