FEET AND TOES
Osteochondromas may occur in the tarsal and carpal bones, however they are often less apparent. Relative shortening of the metatarsals, metacarpals, and phalanges may be noted.
Plain radiographs are probably more useful in defining the extent of involvement of the small bones of the feet in MHE. Other imaging studies may be ordered as and when required.
Possible Treatment Options
Large bumps can be surgically excised when symptomatic
Deformities of the foot (like hallux valgus) may be corrected by stapling of the growing epiphysis in younger children or by surgical osteotomy in older patients.
What Parents Should Watch Out For
Compression of the peroneal nerve, which runs along the outside of the leg, can cause a condition known as “drop foot”, in which the foot cannot voluntarily be flexed up. Compression can be caused by exostoses growth, or as a complication of surgery.
*Note from The MHE Coalition: Parents should know that finding shoes for children affected with ankle and/or foot exostoses can be challenging. Shoes must be found that do not cut into or press on exostoses. In some cases, they must be made specially for the child. In addition, some children will require lifts to help equalize a limb length discrepancy. Children who have exostoses on the bottom of their heel can sometimes benefit from gel cushions that are sold in drug/grocery stores. In addition, many children and teens will have difficulty tying shoes due to affected hands, shortened forearms, etc., and may need shoes with Velcro or shoes that slip on.