Nowadays, orthopedists very often diagnose flatvalgus feet in children.This deformation consists of the sinking of the inner part of the foot.That is, the straight axis that runs from the lower leg to the foot is curved.You can also visually see that the height of the outer arches of the feet is decreasing.The inner longitudinal arch of the foot disappears.A characteristic feature of planovalgus foot deformity in children is the position of the legs in the shape of the letter “X”.This is clearly visible when the child stands upright.
In rare cases, valgus flatfoot can be congenital, but more often it is a deformity that develops in children under 3 years of age.This position of the foot is noticeable during the baby's first steps.At this stage, parents should react and show the child to an orthopedist.
Forms
Valgus flat feet can take two forms: congenital and acquired.Congenital malformations are diagnosed by doctors in the first month of life.This disorder develops during intrauterine development.This often happens due to a genetic predisposition.
Congenital plano-valgus deformities can occur in very severe forms.These are, for example, the tilting foot and the vertical ram.Soft foot is most common in babies with Edwards syndrome.Vertical talus is a complex foot lesion that requires surgery to treat.Most often these are operations on tendons in the form of their transplantation, lengthening or adjustment of the scaphoid bone, etc. However, sometimes they only make do with a plaster cast.
With an acquired deformity, the structure of the foot changes under the influence of various factors.This usually happens due to weak and not yet perfect tendon-ligament systems, etc.
Reasons
The main cause of valgus flatfoot in children is weakness of the musculotendinous aponeurosis of the foot.And since the load on the child's musculoskeletal system is quite large after a year, the legs begin to bend and the feet sink inward.Accordingly, all arches and arches of the feet develop incorrectly.
Factors that cause valgus flatfoot also include:
- Rickets In this disease, the bone tissue becomes brittle and deformed;
- Muscle paralysis.This may occur after polio;
- Simultaneity with other serious diseases – cerebral palsy (CP), polyneuropathy, muscular dystrophy;
- a chronic disease of an infectious or viral nature leading to circulatory problems;
- traumatic injuries to the foot and leg;
- various dysfunctions of the endocrine system.For example, overweight or underweight, diabetes, etc.
- Malnutrition, poor diet, lack of vitamins and minerals in the body.
Doctors point out that hallux valgus can develop due to incorrectly selected shoes for the child.Wearing shoes with flat, soft soles without hard back and instep support is contraindicated.Especially for children under 3-5 years.
The risk group also includes children who lead a sedentary lifestyle when the child does not engage in physical exercise.
Flat valgus feet of the congenital type often occur in premature babies and when the child is underweight in the womb.
Signs and symptoms
Visible signs of this foot deformity in a child include:
- Gait changes.The child walks clumsily, sways his feet, and his steps are unsteady.
- When walking, he mainly steps on the inside of the foot.
- Poor posture and a hunched back are always associated with foot deformities in children.
- The foot is shapeless and condensed.In children, the foot appears bulging.
- X-shaped legs.
Parents may also notice other symptoms in their child:
- tired legs and possibly aches at the end of the day;
- Headache;
- Back pain.
Degree of damage
There are 4 main stages of planovalgus foot deformity.At the initial stage, the curvature is no more than 150.Many children have this disorder, but it can be solved very easily and quickly if parents notice the problem in time.
In the second stage, the curvature of the foot reaches 200.This degree of damage requires longer treatment, but produces a positive result.
In the third stage, comprehensive and long-term treatment of flat valgus in children is required.The heel deviates by 30 at this stage0.And the fourth stage is diagnosed in cases where the curvature is more than 300.This deformity can only be corrected surgically by qualified specialists.
diagnosis
The diagnostic process begins with a visual examination of the child by an orthopedist.To determine the degree of deformity of the child's foot, the child is subsequently referred for further examinations.Among them:
- X-ray – this examination helps the doctor to accurately determine the presence of a hallux valgus and the degree of its development.To do this, the image is recorded in three projections.
- Podometry is a computer diagnostic used when a deformity is suspected and is difficult to diagnose visually.That is, the characters are not expressed.
- Ultrasound examinations are performed in children to assess the condition of the joints and determine whether there are other concomitant diseases.
- Computed plantography is an examination in which the feet are scanned on a special platform.The computer is able to determine various morphological parameters.In this case, the doctor will understand how the load is distributed on the foot.Plantography can also be performed with stress testing.
The orthopedist refers the little patient for a consultation with a neurologist to determine exactly whether there are any diseases of the central nervous system.Other specialists that need to be seen include a surgeon and an endocrinologist.
Treatment
Treatment of flat valgus feet in children is necessary at any stage of the deformity.It depends on the degree of damage.The main goal of therapy is to restore normal foot position.In the first step, it is enough for the child to wear the right orthopedic shoes and engage in physical activity.There are special gymnastics exercises for the feet that parents can playfully do together with their child so that they want to be treated.Sometimes therapeutic massage is also prescribed at this stage.Such treatment measures help to locally strengthen muscles and ligaments.
Conservative treatment of other stages of flat valgus foot in a child consists of paraffin therapy, therapeutic massage and gymnastics.They also use physical therapy in the form of electrophoresis, magnetic or electrical muscle stimulation.
Paraffin therapy is carried out in children's clinics.Paraffin wraps are performed on the entire foot, extending to the shin, like a high boot.After this process you can start the massage.This is very effective as the muscles are softened after paraffin.
If a child has a hallux valgus, therapeutic massage should only be performed 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 consulted the doctor is advanced, surgical treatment is used.
Treatment for planovalgus foot deformity can be done using the Dobbs method.This involves manual correction of the feet and a plaster cast.Approximately 6 procedures are required, carried out one week apart.After each week, the position of the foot changes when watering.The cast begins in the middle of the thigh, the leg is bent at the knee.At the end of this phase of treatment for flat valgus foot, the doctor must fix the talonavicular joint in the correct position.And to secure it, the doctor installs a Kirschner wire that is inserted through the skin.The cast should hold the leg in place for about 2 months.A plaster cast in the shape of a boot is then applied.Next, braces are recommended, i.e. special shoes that have the desired shape.The child should wear them constantly and only put them on after a while during the day and night sleep.
Plano-valgus foot deformity can also be corrected through minimally invasive surgery.This changes the angle between the bones and increases the tension in the ligaments.
Arthrodesis operations in children are performed extremely rarely, as it causes a high level of trauma and pain occurs when walking afterwards.When operating on hallux valgus in children, doctors create a firm connection between the talus and the heel bone, thereby strengthening the muscles of the inner arch.
Consequences
It is very important to diagnose hallux valgus in a timely manner, as the musculoskeletal system becomes increasingly affected as the disease progresses.This is fraught with the appearance of club feet, scoliosis and flat feet.This is also a prerequisite for the appearance of arthrosis, arthritis, diseases of the cervical spine and constant pain in the legs.
Prevention
To maintain the therapeutic effect of therapy, the child must wear special orthopedic shoes.All shoes should reach shin height and have firm arch support.Be it sandals or boots.
You need to purchase an insole for plano valgus feet that can be inserted into any shoe.But only under the condition that they are high shoes.
It is very important that, in addition to daily exercises and an active lifestyle, the child also does foot exercises.It is prescribed by a doctor, but the simplest exercises are:
- Walking on the inside and outside of the foot, on the heel;
- pump a rolling pin or other round object with your feet;
- Pick up objects and paint with your toes;
- Performing foot rotations.