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 that goes from the lower leg to the foot is curved.Visually, it can also be seen that the height of the outer arches of the feet decreases.The inner longitudinal arch of the foot disappears.A characteristic feature of planovalgus deformity of the foot in children is the position of the legs in the shape of the letter "X".This will be clearly visible if the child stands upright.
Valgus flat foot 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 feet 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 foot 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.This often happens due to a genetic predisposition.
Congenital plano-valgus deformity can occur in very severe forms.For example, it is a rocker and a vertical frame.Rocker foot most often develops in babies with Edwards syndrome.Vertical talus is a complex foot lesion, as its treatment requires surgery.Most often, these are tendon operations in the form of their transplantation, lengthening or adjustment of the scaphoid bone, etc.But sometimes they get by with just a cast.
With the acquired form of deformity, the structure of the foot changes under the influence of various factors.This usually happens due to a weak and not yet perfect tendon-ligament apparatus, etc.
Reasons
The main cause of valgus flat foot in children is weakness of the musculotendinous aponeurosis of the foot.And since after a year the load on the child's musculoskeletal system is quite high, the legs begin to bend and the feet sink inward.Consequently, all the arches and arches of the feet develop improperly.
Factors that provoke a valgus flat foot also include:
- rickets In this disease, the bone tissue becomes fragile and deformed;
- muscle paralysis.This can be after polio;
- simultaneously with other serious diseases - cerebral palsy (CP), polyneuropathy, muscular dystrophy;
- a chronic disease of an infectious or viral nature that contributes to circulation problems;
- traumatic foot and leg injuries;
- various dysfunctions of the endocrine system.For example, overweight or underweight, diabetes, etc.
- lack of nutrition, poor diet, lack of vitamins and minerals in the body.
Doctors note that hallux valgus can develop due to improperly selected shoes for a child.It is contraindicated to wear shoes with a flat, soft sole, without a hard support for the back and recoil.Especially for children under 3-5 years old.
The risk group also includes children who lead a sedentary lifestyle if the child does not engage in physical exercises.
Flat-valgus feet of the congenital type often appear in premature babies, and in the case when the child has a lower weight in the womb.
Signs and symptoms
Visible signs of this foot deformity in a child are:
- Changes on the fly.The child walks clumsily, moves his legs, and his steps are uncertain.
- When walking, he mostly steps on the inner part of the foot.
- Bad posture and a bent back always accompany foot deformities in children.
- The foot is shapeless and compact.In case of children, the foot appears fat.
- X-shaped legs.
Parents may also notice other symptoms in their child:
- tired legs and may feel pain at the end of the day;
- headache;
- back pain.
Degree of damage
There are 4 main stages of planovalgus foot deformity.In the initial phase, the curvature does not exceed 150.Many children have this disorder, but it is easily and quickly corrected, provided that the parents have 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, it is necessary to comprehensively treat flat-valgus feet in children, 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 greater than 300.This deformity can only be corrected by qualified specialists through surgery.
Diagnostics
The diagnostic process begins with a visual examination of the child by an orthopedist.Then, in order to determine the degree of deformation of the child's foot, the child is referred to other studies.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, the image is recorded in three projections.
- Podometry is a computer diagnostic that is used when a deformity is suspected if it is difficult to diagnose visually.That is, the signs are not expressed.
- Ultrasound is done in children to determine the condition of the joints and whether there are any other accompanying 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 foot.Plantography can also be performed with stress tests.
The orthopedist will refer the small patient to a consultation with a neurologist in order to accurately determine whether there are diseases of the central nervous system.Other specialists that need to be visited 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 degree of damage.The main goal of therapy is to restore the normal position of the foot.In the first stage, the child will be able to wear correct orthopedic shoes and engage in physical exercises.There are special foot exercises that parents can do together with their child in a playful way to make them want to be treated.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 children consists of paraffin therapy, therapeutic massage and gymnastics.They also use physiotherapy in the form of electrophoresis, magnetic or electrical muscle stimulation.
Paraffinotherapy is carried out in children's clinics.Paraffin wraps are done on the entire foot and extend to the lower leg, like a tall boot.After this procedure you can start the massage.This will be quite effective, because the muscles are softened after the paraffin.
If a child has hallux valgus, therapeutic massage should only be performed by a qualified specialist.You can do this at home if the specialist 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 is advanced, then surgical treatment is used.
Treatment of planovalgus deformity of the foot can be carried out using the Dobbs method.This includes manual correction of the foot and a plaster cast.About 6 procedures are required, which are done at intervals of one week.After each week, the position of the feet during the throw 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 treatment of flat valgus feet, the doctor must fix the talonavicular joint in the correct position.And for fixation, the doctor inserts a Kirschner wire, which is inserted through the skin.The cast should fix the leg for about 2 months.After that, plaster is applied in the form of a boot.Then braces, or special shoes that have the desired shape, are recommended.The child should wear them all the time, and only after some time should they be put on during daytime and nighttime sleep.
Plano-valgus deformity of the foot can also be corrected with minimally invasive surgeries.This changes the angle between the bones and, as a result, increases the tension of the ligaments.
Arthrodesis operations in children are used extremely rarely, because it results in 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 a timely manner, because as the disease progresses, the musculoskeletal system will be increasingly affected.This is fraught with the appearance of clubfoot, 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
In order 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.Whether it's sandals or boots.
It is necessary to purchase an insole for plano-valgus feet, which can be inserted into any shoe.But only if they are high shoes.
It is very important that the child, in addition to daily exercises and an active lifestyle, does gymnastics for the feet.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;
- lifting objects and painting with toes;
- performing foot rotations.