Today, orthopedists very often diagnose flatvalgus feet in children.This deformity consists of the sinking of the inner part of the foot.That is, the straight axis from the leg to the foot is curved.You can also visually see that the height of the outer arches of the foot decreases.The inner longitudinal arch of the foot disappears.A characteristic feature of planovalgus foot deformity in children is the position of the feet in the form of the letter "X".This will be clearly visible when the child is standing straight.
In rare cases, valgus flatfoot can be congenital, but it is more often 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.
Forms
Valgus flatfoot can be of two types: congenital and acquired.Congenital deformity is diagnosed by doctors already in the first month of life.This disorder develops during intrauterine development.This is often due to a genetic predisposition.
Congenital plano-valgus deformity can occur in very severe forms.Examples include the tilting base and the vertical arm.Most often, babies with Edwards syndrome develop a humpback.Vertical talus is a complex foot change, as its treatment requires surgery.Most often, these are tendon surgeries that involve transplanting, lengthening, adjusting, etc. of the humerus.
With the acquired form of the deformity, the structure of the foot changes under the influence of various factors.This is usually due to a weak and not yet perfect ligament apparatus, etc.
Reasons
The main reason for the development of valgus flat feet in children is the weakness of the muscle-aponeurosis of the foot.And since after a year the load on the child's musculoskeletal system is quite large, the legs begin to bend and the feet sink inward.Accordingly, all arches and arches of the foot develop incorrectly.
The factors that cause the development of valgus flat feet are also the following:
- rickets With this disease, the bone tissue becomes fragile and deformed;
- muscle paralysis.This can be after polio;
- simultaneity with 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.Wearing shoes with flat, soft soles, without hard back and foot support is not recommended.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.
Congenital flat-valgus feet often appear in premature babies and if the child is underweight in the womb.
Signs and symptoms
Visible signs of foot deformity in children:
- Changes in gait.The child walks awkwardly, shakes his legs, his steps are uncertain.
- When walking, it mainly steps on the inside of the foot.
- In children, poor posture and a bent back always accompany foot deformities.
- The foot is shapeless and compact.In children, the foot appears rounded.
- X-shaped legs.
Parents may notice other symptoms in their child:
- tired legs and may experience pain at the end of the day;
- headache;
- backache.
Degree of damage
There are 4 main stages of planovalgus foot deformity.In the initial stage, the curvature does not exceed 150.Many children have this disorder, but it can be 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.
In the third stage, children's flat-valgus feet should be comprehensively treated, and the treatment will be long-term.The heel in this section differs by 300.And the fourth stage is diagnosed in cases where the curvature exceeds 300.Only qualified specialists can correct this deformity with surgery.
Diagnostics
The diagnostic process begins with a visual examination of the child by an orthopedic doctor.The child is then referred to other tests to determine the extent of the child's foot deformity.Among them:
- X-ray - this study helps the doctor to accurately determine the presence of hallux valgus and the extent of its development.For this, the image is made in three projections.
- Pedometry is a computerized diagnosis that is used when a deformity is suspected, when it is difficult to diagnose visually.That is, the signs are not expressed.
- Ultrasound is performed on children to understand the condition of the joints and whether there are other accompanying diseases.
- Computerized plantography is an examination in which the feet are scanned on a special platform.The computer is capable of determining various morphological parameters.In this case, the doctor understands how the load on the leg is distributed.Plantography can also be done with stress tests.
The orthopedic neurologist refers the little patient to a consultation in order to accurately determine whether there are central nervous system diseases.Other specialists to visit are 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 extent of the damage.The main goal of the therapy is to restore the normal position of the foot.In the first stage, it is sufficient if the child wears suitable orthopedic shoes and exercises.There are special leg exercises that parents can do in a playful way with their child so that they want to treat him.Sometimes a therapeutic massage is also prescribed at this stage.Such treatment measures promote local strengthening of muscles and ligaments.
Conservative treatment of the other sections of the flat-valgus foot in children consists of paraffin therapy, therapeutic massage and gymnastics.Physiotherapy is also used in the form of electrophoresis, magnetic or electrical muscle stimulation.
Paraffin therapy is performed in children's clinics.Paraffin wraps go all over the leg and shin like a tall boot.After the procedure, you can start the massage.This will be quite effective, as the muscles soften after the paraffin.
If the child suffers from hallux valgus, the therapeutic massage can only be performed by a qualified specialist.You can also do it at home if a professional has given permission and instructed your parents.
Surgical treatment
If all methods of conservative treatment have no effect, or the stage in which the parents consulted a doctor was advanced, then surgical treatment is used.
Planovalgus foot deformity can be treated using the Dobbs method.This includes manual correction of the legs and casting of plaster casts.Approximately 6 procedures are required, which are performed at intervals of one week.After every week, the position of the leg changes during the cast.The cast starts from the middle of the thigh, with the leg bent at the knee.At the end of this phase of treatment for flat valgus feet, the doctor must fix the talonavicular joint in the correct position.For fixation, the doctor installs a Kirschner wire, which is inserted through the skin.The cast should hold the leg for about 2 months.After that, a plaster cast is applied in the form of a boot.Next, braces are recommended, i.e. special shoes that have the desired shape.The child should wear them continuously and only take them off after a certain period of time during daytime and nighttime sleep.
Plano-valgus foot deformity can also be corrected with minimally invasive surgeries.This changes the angle between the bones and consequently increases the tension in the ligaments.
Arthrodesis-type surgeries in children are extremely rarely used, as this results in a high level of trauma and is followed by 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 becomes more and more 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, diseases of the cervical spine and constant pain in the legs.
Prevention
In order to maintain the therapeutic effect of the therapy, the child must wear special orthopedic shoes.All shoes should reach the level of the shin and have a rigid arch support.Be it sandals or boots.
Buy an insole for plano-valgus feet that can be inserted into any shoe.But only on the condition that these are high shoes.
It is very important that the child does leg exercises in addition to doing daily exercises and an active lifestyle.A doctor prescribes it, but the simplest exercises are the following:
- walking on the inside and outside of the foot, in the heel;
- pumping a rolling pin or other round object with your feet;
- picking up objects and painting with toes;
- performing leg rotations.