Today, orthopedists frequently diagnose flatvalgus feet in children.This deformity consists of sinking the inside of the foot.That is, the straight axis that goes from the bottom of the foot to the foot is curved.Visually, you can also see that the height of the outer arch of the foot is reduced.The internal longitudinal arch of the foot is missing.A characteristic feature of planovalgus foot deformity in children is the position of the foot in the shape of the letter "X".This will be clearly visible if the child is standing upright.
Flatfoot valgus in rare cases can be congenital, but more often it is a deformity that develops in children under 3 years of age.This position of the foot becomes noticeable when the baby takes its first steps.At this stage, parents should react and show the child to an orthopedist.
Form
Valgus flatfoot can be of two forms: congenital and acquired.Congenital defects are diagnosed by doctors in the first month of life.This disorder develops during intrauterine development.Often this happens because of genetic predisposition.
Congenital plano-valgus deformity can occur in very severe forms.For example, these are rocker legs and vertical vanes.Wobbly legs most often develop in babies with Edwards syndrome.Vertical talus is a complex foot lesion, as its treatment requires surgery.Often this is an operation on the tendon in the form of transfer, lengthening, or adjustment of the scaphoid bone, etc.But sometimes it survives only with a plaster cast.
With the shape of the obtained deformation, the structure of the foot changes under the influence of various factors.This usually occurs due to a weak and immature tendon-ligament apparatus, etc.
The reasons
The main cause of valgus flatfoot in children is 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.Therefore, all arches and arches of the foot develop incorrectly.
Factors that trigger flatfoot valgus also include:
- rickets With this disease, bone tissue becomes fragile and deformed;
- muscle paralysis.This may be after polio;
- along with other serious diseases - cerebral palsy (CP), polyneuropathy, muscular dystrophy;
- chronic diseases of an infectious or viral nature that contribute to circulatory problems;
- traumatic injuries to the legs and feet;
- various endocrine system dysfunctions.For example, overweight or underweight, diabetes, etc.
- lack of nutrition, poor nutrition, lack of vitamins and minerals in the body.
Doctors note that hallux valgus can develop due to improperly selected shoes for the child.Wearing shoes with flat, soft soles, without hard backs and heel support is contraindicated.Especially for children under the age of 3-5 years.
The risk group also includes children who lead a sedentary lifestyle if the child does not do any physical exercise.
Congenital flat-valgus feet often appear in premature babies, and in cases when the child is underweight in the womb.
Signs and symptoms
Signs of foot deformities that can be seen in children are:
- Changes in gait.The child walks awkwardly, shuffles his feet, and his steps are unsteady.
- When walking, he mainly steps on the inside of the foot.
- Poor posture and stooping back always accompany foot deformities in children.
- Legs are shapeless and dense.In the case of children, the legs appear plump.
- X-shaped legs.
Parents may also notice other symptoms in their child:
- feet are tired and may be sore at the end of the day;
- headache;
- back pain
Level of damage
There are 4 main stages of planovalgus foot deformity.At the initial stage, the curvature does not exceed 150.Many children suffer from this disorder, but it is very easy and quick to correct, provided the parents notice the problem in time.
In the second stage, the curvature of the legs reaches 200.This level of damage requires longer treatment, but it gives positive results.
In the third stage, it is necessary to treat flat feet-valgus in children comprehensively, and the treatment will be long-term.The heel at this stage deviates by 300.And the fourth stage is diagnosed in cases where the curvature becomes more than 300.This defect can only be corrected by a qualified specialist through surgery.
Diagnostics
The diagnostic process begins with a visual examination of the child by an orthopedic doctor.Next, to determine the degree of deformation of the child's foot, the child is referred for another study.Among them:
- X-ray - this study helps the doctor to accurately determine the presence of hallux valgus and the degree of its development.To do this, pictures are taken in three projections.
- Podometry is a computer diagnostic used when a disability is suspected if it is difficult to diagnose visually.That is, the signs are not specified.
- Ultrasound is performed on children to understand the condition of the joints and whether there are any other concomitant diseases.
- Computerized plantography is a study where the feet are scanned on a special platform.Computers can determine various morphological parameters.In this case, the doctor will understand how the load on the leg is distributed.Plantography can also be carried out with a stress test.
The orthopedist will refer the small patient to consult a neurologist to determine exactly whether there is a disease of the central nervous system.Other specialists to visit are surgeons and endocrinologists.
Treatment
Treatment of flat feet-valgus in children is necessary at any stage of deformity.It depends on the level of damage.The main goal of therapy is to restore the normal position of the foot.In the first stage, it is enough for the child to wear the correct orthopedic shoes and do physical exercises.There are special gymnastics for legs that parents can do together with their child playfully so that he wants to be treated.Sometimes at this stage a course of therapeutic massage is also prescribed.Such treatment measures help strengthen muscles and ligaments locally.
Conservative treatment for other stages of flat-valgus feet in children 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 at the children's clinic.Paraffin wraps are done on the entire leg and extended over the shins, like high boots.After this procedure, you can start the massage.This will be quite effective, because the muscles become soft after paraffin.
If the child has hallux valgus, then the therapeutic massage should only be performed by a qualified specialist.You can do it at home if the specialist has given permission and instructed your parents.
Surgical treatment
If all conservative treatment methods have no effect or the stage at which the parents turn to the doctor has progressed, then surgical treatment is used.
Treatment of planovalgus foot deformity can be carried out using the Dobbs method.This involves manual correction of the leg 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 feet during casting changes.Cast starts from the middle of the thigh, the leg is bent at the knee.At the end of this stage of treatment for flat valgus feet, the doctor must fix the talonavicular joint in the correct position.And for fasteners, the doctor installs a Kirschner wire, which is inserted through the skin.The actor should fix the leg for about 2 months.After this, a plaster cast is used in the form of a boot.Next, braces are recommended, which are special shoes that have the desired shape.Children should wear it continuously, and only after some time should it be worn during daytime and nighttime naps.
Plano-valgus foot deformities can also be corrected using minimally invasive surgery.This changes the angle between the bones and, as a result, the ligament tension increases.
Arthrodesis-type operations for children are very rarely used, because this results in a high degree of trauma, and afterwards there is pain when walking.During surgery on hallux valgus in children, the doctor makes a permanent connection between the talus and the calcaneus, thereby strengthening the internal arch muscles.
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 club feet, scoliosis, and flat feet.This is also a prerequisite for the appearance of arthrosis, arthritis, cervical spine disease and constant pain in the legs.
Prevention
To maintain the therapeutic effect of therapy, children must wear special orthopedic shoes.All shoes should reach shin level and have firm arch support.Either sandals or boots.
You need to buy insoles for plano-valgus feet, which can be inserted into any shoe.But only with the condition that these are high shoes.
It is very important that the child, in addition to doing daily exercises and leading an active lifestyle, does 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 your foot;
- pick up objects and draw with your toes;
- perform leg rotation.