Today, orthopedists very often diagnose flatfoot valgus in children.This deformation consists in the sinking of the internal part of the foot.That is, the straight axis going from the lower leg 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 planovalgus foot deformity in children is the position of the legs in the form of the letter "X".This will be clearly visible if the child stands straight.
Flatfoot valgus can in rare cases be congenital, but more often it is a deformity that develops in children under 3 years of age.This foot position becomes evident when the baby takes his first steps.At this stage, parents should react and show the child to an orthopedist.
Shapes
Valgus flatfoot can be of two forms: congenital and acquired.Congenital deformity is diagnosed by doctors already during the first month of life.This disorder develops during intrauterine development.Most often this occurs due to genetic predisposition.
Congenital plano-valgus deformity can occur in very severe forms.For example, these are the swing foot and the vertical piston.Rocker foot develops more often in children with Edwards syndrome.Vertical talus is a complex lesion of the foot, since its treatment requires surgical intervention.Most often these are tendon operations in the form of transplantation, lengthening or adjustment of the scaphoid bone, etc.But sometimes they succeed only with plaster casting.
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.As a result, all arches and arches of the foot develop incorrectly.
Factors that cause flatfoot valgus also include:
- rickets With this disease the bone tissue becomes fragile and deformed;
- muscle paralysis.This could happen 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 injuries of the foot and leg;
- 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 chosen shoes for the child.It is contraindicated to wear shoes with a flat, soft sole, without hard support for the back and instep.Especially for children under 3-5 years old.
The risk group also includes children who lead a sedentary lifestyle if they do not do any physical exercise.
Congenital valgus flat feet often appear in premature babies and when the baby is underweight in the womb.
Signs and symptoms
The visible signs of this foot deformity in a child are:
- Changes in gait.The child walks awkwardly, shuffles his feet, and his steps are unsteady.
- When walking, he steps mainly on the inside of his foot.
- Poor posture and hunched back always accompany foot deformities in children.
- The foot is shapeless and compact.In the case of children, the foot appears fleshy.
- X-shaped legs.
Parents may also notice other symptoms in their child:
- tired legs and may feel pain at the end of the day;
- heachache;
- 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 suffer from this disorder, but it can be corrected very easily and quickly, provided that parents notice it in time.
In the second phase 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 treat flatfoot valgus in children comprehensively, and the treatment will be long-term.The heel in this phase deviates by 300.And the fourth stage is diagnosed in cases where the curvature exceeds 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 orthopedic doctor.Subsequently, to determine the degree of deformation of the child's foot, the child is subjected to other studies.Among these:
- X-ray - this study helps the doctor accurately determine the presence of hallux valgus and the degree of its development.To do this, the image is taken 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.
- Ultrasounds are performed on children to understand the state 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 on the foot is distributed.Plantography can also be carried out 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 who will need to be seen are a surgeon and an endocrinologist.
Treatment
Treatment of valgus flatfoot in children is necessary at any stage of the deformity.It depends on the extent of the damage.The main goal of therapy is to restore the normal position of the foot.In the first phase it will be sufficient for the child to wear the correct orthopedic shoes and practice physical exercise.There are special foot gymnastics that parents can do in a playful way together with their child so that he wants to seek treatment.Sometimes a course of therapeutic massage is also prescribed at this stage.Such therapeutic measures help to locally strengthen muscles and ligaments.
Conservative treatment for other stages of flat foot valgus in a child 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 in children's clinics.Paraffin compresses are applied to the entire foot and extend up to the shin, like a high boot.After this procedure, you can start massage.This will be quite effective, as the muscles will 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 permission and instructed your parents.
Surgical treatment
If all conservative treatment methods had no effect or the stage at which the parents turned to the doctor was advanced, surgical treatment is used.
Treatment of planovalgus foot deformity can be done using the Dobbs method.This involves manual correction of the feet and casting in plaster.Approximately 6 procedures are required, which are performed at one-week intervals.After each week, the position of the foot during the throw changes.The cast starts from the middle of the thigh, the leg is bent at the knee.At the end of this phase 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.Next, a plaster cast in the form of a boot is applied.Next, braces are recommended, that is, special shoes that have the desired shape.The child should wear them constantly and only after some time they should be worn during day and night sleep.
Planovalgus foot deformity can also be corrected through minimally invasive surgeries.This changes the angle between the bones and, as a result, increases the tension of the ligaments.
Arthrodesis-type operations for children are used very rarely, as this causes a high level of traumatism and after them pain occurs when walking.During surgery on hallux valgus in children, doctors create a fixed connection between the talus and the calcaneus, thereby strengthening the muscles of the internal 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 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 specialized orthopedic shoes.All shoes should reach the level of the shin and have rigid arch support.Be it sandals or boots.
You need to purchase a plano-valgus foot insole, 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:
- walk 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;
- perform foot rotations.