Today, orthopedists very frequently diagnose valgus flatfoot in children.This deformation consists of the sinking of the inner part of the foot.That is, the straight axis that goes from the calf to the foot is curved.Visually you can also see that the height of the outer arches of the foot decreases.The internal longitudinal arch of the foot disappears.A characteristic feature of the planavalgus foot deformity in children is the position of the legs in the shape of the letter "X".This will be clearly visible if the child stands up.
In rare cases, flatfoot valgus 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 when the baby takes his first steps.At this stage, parents should react and show the child to an orthopedist.
Forms
Flat valgus feet can be of two forms: congenital and acquired.Doctors diagnose the congenital deformity as early as the first month of life.This disorder develops during intrauterine development.Most often this occurs due to a genetic predisposition.
Congenital plana-valgus deformity can occur in very severe forms.For example, these are the tilting foot and the vertical ram.Rocking foot develops more often in babies with Edwards syndrome.Vertical talus is a complex foot injury, since its treatment requires surgery.In most cases these are operations on the tendons in the form of transplantation, lengthening or adjustment of the scaphoid bone, etc.But sometimes they get by with just plaster.
With an acquired form of deformity, the structure of the foot changes under the influence of various factors.This usually occurs due to a weak and not yet perfect tendon-ligament apparatus, etc.
Reasons
The main cause of flatfoot valgus 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 feet sink inward.Consequently, all arches and arches of the foot develop incorrectly.
Factors that cause flatfoot valgus also include:
- rickets With this disease, bone tissue becomes fragile and deformed;
- muscle paralysis.This may be after polio;
- concomitant 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 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 incorrectly selected shoes for the child.The use of shoes with flat, soft soles, without hard backing or support for the instep, is contraindicated.Especially for children under 3-5 years old.
The risk group also includes children who lead a sedentary lifestyle if they do not engage in any physical exercise.
Congenital valgus flat feet often appear in premature babies and in the event that the child is underweight in the womb.
Signs and symptoms
Visible signs of this foot deformity in a child are:
- Changes in gait.The child walks with difficulty, shuffles his feet, and his steps are unsteady.
- When walking, you step mainly on the inside of your foot.
- Poor posture and a hunched back always accompany foot deformities in children.
- The foot is shapeless and compacted.In children, the foot appears chubby.
- X-shaped legs.
Parents may also notice other symptoms in their children:
- tired legs and may experience pain at the end of the day;
- headache;
- backache.
Damage degree
There are 4 main stages of the planavalgus foot deformity.At the initial stage, the curvature does not exceed 15.0.Many children suffer from this disorder, but it is corrected very easily and quickly, as long as 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 gives a positive result.
In the third stage, the treatment of flatfoot-valgus in children is necessary in a comprehensive manner and the treatment will be long-term.The heel at this stage deviates 300.And the fourth stage is diagnosed in cases where the curvature exceeds 30.0.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.Next, to determine the degree of deformation of the child's foot, the child is referred for further 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 photograph is taken in three projections.
- Podometry is a computer diagnostic used when a deformity is suspected if it is difficult to diagnose visually.That is, the signs are not expressed.
- Ultrasounds are performed on children to understand 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 is capable of determining various morphological parameters.In this case, the doctor will understand how the load is distributed on the foot.Plantography can also be done with stress tests.
The orthopedist will refer the little patient for a consultation with a neurologist to accurately determine whether there are diseases of the central nervous system.Other specialists that will need to be visited are a surgeon and an endocrinologist.
Treatment
Treatment of flatfoot-valgus in children is necessary at any stage of 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, it will be enough for the child to wear appropriate orthopedic footwear and do physical exercise.There are special gymnastics for the feet that parents can do together with their child in a playful way so that they want to be treated.Sometimes a course of therapeutic massage is also prescribed at this stage.These treatment measures help to strengthen muscles and ligaments locally.
Conservative treatment for other stages of valgus flatfoot 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 done on the entire foot and extend to the shin, like a tall boot.After this procedure, you can start the massage.This will be quite effective, since the muscles soften after paraffin.
If a child has hallux valgus, therapeutic massage should be performed only by a qualified specialist.You can do it at home if a specialist has given you permission and instructed your parents.
Surgical treatment
If all conservative treatment methods have no effect or the stage at which the parents went to the doctor was advanced, then surgical treatment is used.
Treatment of the planavalgus foot deformity can be performed using the Dobbs method.This involves manual correction of the feet and casting.About 6 procedures are required, which are carried out with an interval of one week.After each week, the position of the foot during the cast changes.The cast starts from the middle of the thigh, the leg is bent at the knee.At the end of this stage of flatfoot valgus treatment, the doctor must fix the talonavicular joint in the correct position.And for fixation, the doctor installs a Kirschner wire, which is inserted through the skin.The cast should fix the leg for about 2 months.After this, a boot-shaped cast is applied.Suspenders are recommended next, 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.
Flatfoot-valgus deformity can also be corrected through minimally invasive surgeries.This changes the angle between the bones and, as a result, increases tension on the ligaments.
Arthrodesis-type operations in children are very rarely used, as this causes a high level of trauma and then pain appears 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, since 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 osteoarthritis, arthritis, diseases of the cervical spine and constant pain in the legs.
Prevention
To maintain the therapeutic effect of therapy, the child must wear specialized orthopedic footwear.All shoes should reach shin level and have rigid arch support.Whether sandals or boots.
You need to purchase an insole for flat-valgus feet, which can be inserted into any shoe.But only on the condition that they are high shoes.
It is very important that the child, in addition to doing daily exercises and leading an active lifestyle, does foot gymnastics.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 roller or other round object with your feet;
- pick up objects and paint with your toes;
- perform foot rotations.