Today, orthopedists very often diagnose flat valgus feet in children.This deformity consists in a sinking of the inner part of the foot.That is, the straight axis that passes from the lower leg to the foot is curved.Visually, you can also see that the height of the outer arches of the foot decreases.The inner longitudinal arch of the foot disappears.A characteristic feature of the flat valgus deformity of the foot in children is the position of the legs in the form of the letter "X".This will be clearly visible if the child is standing upright.
Valgus flatfoot in rare cases can be congenital, but more often it is a deformity that develops in children under 3 years of age.This leg position becomes noticeable when the baby takes its first steps.At this stage, parents should react and show the child to an orthopedist.
forms
Valgus flat feet can be in two forms: congenital and acquired.Congenital deformity is diagnosed by doctors already in the first month of life.This disorder develops during intrauterine development.Quite often this is due to a genetic predisposition.
Congenital plano-valgus deformity can appear in very severe forms.For example, these are the rocker and the vertical ram.Rocker's foot most often develops in babies with Edwards syndrome.Vertical talus is a complex lesion of the foot because its treatment requires surgery.Most often, these are tendon operations in the form of transplantation, lengthening or correction of the scaphoid bone, etc.But sometimes they only manage with a plaster cast.
With an acquired form of deformation, the structure of the foot changes under the influence of various factors.This is usually due to a weak and still imperfect tendon-ligament apparatus, etc.
Reasons
The main cause of valgus flat foot in children is the weakness of the musculotendinous aponeurosis of the foot.And since after a year the child's load on the musculoskeletal system is quite large, the legs begin to bend and the legs sink inward.Accordingly, all the arches and arches of the foot develop incorrectly.
Factors that provoke valgus flat feet also include:
- rickets In this disease, the bone tissue becomes brittle and deformed;
- muscle paralysis.This may be after polio;
- accompanying other serious diseases - cerebral palsy (CP), polyneuropathy, muscular dystrophy;
- a chronic disease of an infectious or viral nature that contributes to circulatory problems;
- traumatic injuries of the foot and leg;
- various dysfunctions of the endocrine system.For example, overweight or underweight, diabetes, etc.
- lack of nutrition, improper nutrition, lack of vitamins and minerals in the body.
Doctors note that hallux valgus can develop due to improperly selected shoes for the child.It is contraindicated to wear shoes with a flat, soft sole, without a hard back and pad.Especially for children under 3-5 years old.
The risk group also includes children who lead a sedentary lifestyle if the child does not do any physical exercise.
Flat-valgus feet of the congenital type often appear in premature babies and in cases where the child is overweight in the womb.
Signs and symptoms
The visible signs of this foot deformity in a child are:
- Gait changes.The child walks uncomfortably, his legs wobble, his steps are uncertain.
- When walking, he steps mainly on the inner part of the foot.
- Poor posture and a hunched back always accompany foot deformities in children.
- The sole is shapeless and compacted.In children, the foot appears rounded.
- X-shaped legs.
Parents may also notice other symptoms in their child:
- tired legs and you may feel pain at the end of the day;
- headache;
- back pain.
Degree of impairment
There are 4 main stages of flat valgus deformity of the foot.In the initial stage, the curvature does not exceed 150.Many children have this disease, but it is corrected very easily and quickly, provided that the parents noticed the problem in time.
In the second stage, the curvature of the foot reaches 200.This degree of damage requires longer treatment, but gives a positive result.
At the third stage, it is necessary to treat flat valgus feet in children in a comprehensive way, and the treatment will be long-term.The fifth at this stage deviates by 300.And the fourth stage is diagnosed in cases where the curvature becomes more than 300.This deformity can only be corrected by qualified specialists through surgery.
Diagnosis
The diagnostic process begins with a visual examination of the child by an orthopedic doctor.Then, to determine the degree of deformity of the child's foot, the child is referred to other tests.Among them:
- X-ray examination - this examination helps the doctor to accurately determine the presence of hallux valgus and the degree of its development.To do this, the photo is taken in three projections.
- Podometry is a computerized diagnosis that is used when a deformity is suspected, if it is difficult to diagnose visually.That is, the signs are not expressed.
- Children undergo an ultrasound scan to find out the condition of the joints and whether there are other concomitant diseases.
- Computerized plantography is a study in which the feet are scanned on a specialized platform.The computer can determine various morphological parameters.In this case, the doctor will understand how the load is distributed on the leg.Plantography can also be done with stress tests.
The orthopedist will refer the little patient for a consultation with a neurologist to determine exactly if there are diseases of the central nervous system.Other specialists who will need to be seen are a surgeon and an endocrinologist.
Treatment
Treatment of flat valgus feet in children is necessary at every stage of the deformity.It depends on the degree of disability.The main goal of the therapy is to restore the normal position of the foot.At the first stage, it will be enough for the child to wear the right orthopedic shoes and do physical exercises.There is a special gymnastics for the feet that parents can perform together with their child in a fun way so that he wants to treat himself.Sometimes a course of therapeutic massage is also prescribed at this stage.Such treatment measures help strengthen muscles and ligaments locally.
Conservative treatment of other stages of flat-valgus foot in a child consists of paraffin therapy, therapeutic massage and gymnastics.They also use physiotherapy in the form of electrophoresis, magnetic or electrical muscle stimulation.
Paraffin therapy is carried out in children's clinics.Paraffin wraps are made over the entire leg and extend over the shin, like high boots.After this procedure you can start the massage.This will be quite effective, since the muscles are softened after paraffin.
If the child has hallux valgus, then therapeutic massage should be performed only by a qualified specialist.You can do it at home if a specialist has given permission and instructed your parents.
Surgical treatment
If all methods of conservative treatment have no effect or the stage at which the parents turned to the doctor is advanced, then surgical treatment is used.
The treatment of flat valgus deformity of the foot can be done using the Dobbs method.This includes manual correction of the feet and a plaster cast.About 6 procedures are required, which are carried out at intervals of one week.After each week, the position of the foot during the cast is changed.The cast starts from the middle of the thigh, the leg is bent at the knee.At the end of this stage of the treatment of flat valgus feet, the doctor must fix the talonavicular joint in the correct position.And for anchoring, the doctor installs a Kirchner wire, which is inserted through the skin.The cast should fix the leg for about 2 months.A plaster cast is then placed in the form of a boot.After that, braces are recommended, that is, special shoes that have the desired shape.The child should wear them constantly and only after a while should they be put on during day and night sleep.
Flat-valgus deformity of the foot can also be corrected through minimally invasive surgeries.This changes the angle between the bones and, as a result, increases the stress on the ligaments.
Arthrodesis-type operations in children are used extremely rarely, because it leads to a high degree of trauma and after them there is pain when walking.During hallux valgus surgery in children, doctors create a fixed connection between the talus and the calcaneus, thereby strengthening the muscles of the inner arch.
Consequences
It is very important to diagnose hallux valgus in time, because as the disease progresses, the musculoskeletal system will be increasingly affected.This is fraught with the appearance of flat feet, scoliosis and flat feet.This is also a prerequisite for the appearance of arthrosis, arthritis, diseases of the cervical spine and constant leg pain.
Prevention
To maintain the therapeutic effect of the therapy, the child must wear specialized orthopedic shoes.All shoes should reach the level of the shin and have firm arch support.Be it sandals or boots.
You should purchase a flat valgus foot insole that can fit into any shoe.But only on the condition that these are high shoes.
It is very important for the child, in addition to doing daily exercises and leading an active lifestyle, to do gymnastics for the legs.It is prescribed by a doctor, but the simplest exercises are:
- walking on the inside and outside of the foot, on the heel;
- pumping a rolling pin or other round object with the feet;
- picking up objects and drawing with toes;
- performing leg rotation.