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Question:
This is a repeat question. I sent it to you a couple of days ago, but you never responded, so I believe the question got lost and never got to you. My 14-year old sister has curvature of the spine, problems with salt metabolism (since birth), flat foot and one of her legs is 1.4 cm shorter than the other (according to the doctor she saw, this is because of her flatfoot, which caused curvature of the spine and resulted in different length of her legs). The doctor told her that she should exercise more to build muscle and told her she should wear special soles in her footwear to cure the flat foot, but it doesn't seem sufficient to me. Do you think this treatment is sufficient or should we do other things like massage? I have heard curvature of the spine can be cured by surgery, but we don't want her to go under the knife and would prefer conservative treatment. We are mainly concerned about the curvature of the spine and different length of the legs, as it looks like the problem will aggravate as she grows up. Can something be done in our situation in addition to exercising and wearing soles? Thanks in advance and I'm looking forward to your reply.
AV
Answer:
Thank you for your inquiry. It's not clear from your description whether the reason given for the curvature / 'short foot' relationship is likely; i.e. are the legs actually shorter when measured carefully from their common points of attachment in the pelvis, or is one leg apparently shorter than the other because the pelvis is tilted due to a primary scoliosis (= spinal curvature)? This is often difficult to assess and a paediatric orthopedic specialist should see the child. If this has already been done, and the recommendation is the build up one foot with a larger shoe because the spine is not tilted and the leg is actually shorter when measured with the pelvis level, then this is a satisfactory means of 'treatment'. 1.4 cm is not a large amount to build up a shoe, especially as the whole length does not have to be compensated for (many people have legs of different lengths if you measure them accurately). Surgery to straighten a curved spine is possible, and often desirable to prevent a host of problems in later life, but is a highly skilled area especially in children. Hope this helps
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