Today, orthopedists very often diagnose flatvalgus feet in children.This deformation consists of the sinking of the internal part of the foot.That is to say, the straight axis that goes from the bottom of the leg to the foot is curved.Visually, you can also see that the height of the outer arch 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 shape of the letter “X”.This will be clearly visible if the child stands up straight.
Valgus flatfoot can in rare cases be congenital, but it is most often a deformity that develops in children under 3 years old.This foot position becomes noticeable from the baby's first steps.At this stage, parents should react and show the child to an orthopedist.
Forms
Valgus flat foot can be of two forms: congenital and acquired.Doctors diagnose birth defects in the first month of life.This disorder develops during intrauterine development.Very often this is due to a genetic predisposition.
Congenital planovalgus deformity can occur in very severe forms.These include, for example, the rocker foot and the vertical cylinder.Rocker foot most often develops in babies with Edwards syndrome.Vertical talus is a complex foot injury because its treatment requires surgery.Most often these are operations on tendons in the form of transplantation, lengthening or adjustment of the scaphoid bone, etc.But sometimes they only get by with a cast.
With an acquired form of deformation, the structure of the foot changes under the influence of various factors.This usually occurs due to a weak and not yet perfect tendon-ligamentous 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 significant, the legs begin to bend and the feet sink inwards.As a result, all arches and arches develop poorly.
Factors that cause flatfoot valgus also include:
- rickets With this disease, bone tissue becomes fragile and deformed;
- muscle paralysis.Maybe it's after polio;
- concomitance 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 incorrectly chosen shoes for the child.Wearing shoes with flat, flexible soles, without rigid support on the back and instep, is contraindicated.Especially for children under 3 to 5 years old.
The risk group also includes children who lead a sedentary lifestyle if the child does not engage in any physical exercise.
Valgus flat feet of the congenital type often appear in premature babies and in the case when the child has insufficient weight in the womb.
Signs and symptoms
The visible signs of this foot deformity in a child are:
- Changes in approach.The child walks clumsily, shuffles his feet and his steps are unsteady.
- When walking, he walks mainly on the inner part of the foot.
- Poor posture and a hunched back always accompany foot deformities in children.
- The foot is shapeless and compacted.In children, the foot appears plump.
- X-shaped legs.
Parents may also notice other symptoms in their child:
- legs tired 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.At the initial stage, the curvature does not exceed 150.Many children suffer from this disorder, but it is corrected very easily and quickly, provided that parents notice the problem in time.
Secondly, the curvature of the foot reaches 200.This degree of damage requires longer treatment, but it gives a positive result.
At the third stage, it is necessary to treat valgus flat feet in children comprehensively, and the treatment will be long-term.The heel at this point deviates by 300.And the fourth stage is diagnosed in cases where the curvature becomes more than 300.This deformity can only be corrected by qualified specialists surgically.
Diagnosis
The diagnostic process begins with a visual examination of the child by an orthopedist.Then, to determine the degree of deformation of the child's foot, it 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 photo is taken in three projections.
- Podometry is a computer diagnostic used when a deformity is suspected if it is difficult to diagnose visually.In other words, the signs are not expressed.
- Ultrasound scans 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 carried out with strength tests.
The orthopedist will refer the little patient to a consultation with a neurologist in order to accurately determine whether there are diseases of the central nervous system.Other specialists who will need to be consulted are a surgeon and an endocrinologist.
Treatment
Treatment of valgus flat feet 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.Initially, it will be enough for the child to wear suitable orthopedic shoes and do physical exercise.There are special gymnastics for the feet that parents can do in a fun way with their child so that he wants to be treated.Sometimes at this stage a course of therapeutic massage is also prescribed.Such therapeutic measures help to locally strengthen muscles and ligaments.
Conservative treatment of other stages of flatfoot-valgus in a child consists of paraffin therapy, therapeutic massage and gymnastics.They also resort to physiotherapy 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 and extend to the shin, like a high boot.After this procedure, you can start the massage.This will be very effective, since the muscles are softened after the paraffin.
If a child suffers from hallux valgus, therapeutic massage should only be carried out by a qualified specialist.You can do this 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 turned to the doctor is advanced, then surgical treatment is used.
Treatment of planovalgus foot deformity can be performed using the Dobbs method.This involves manual correction of the feet and a plaster cast.Approximately 6 procedures are required, carried out at intervals of a week.After each week, the position of the foot when throwing changes.The cast begins in the middle of the thigh, the leg is bent at the knee.At the end of this stage of the treatment of valgus flat feet, the doctor must fix the talonavicular joint in the correct position.And for fixation, the doctor installs a Kirschner wire inserted through the skin.The cast should fix the leg for about 2 months.After that, a boot-shaped plaster is applied.Then braces are recommended, that is, special shoes with the desired shape.The child must wear them constantly and only after a while 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 therefore the tension in the ligaments increases.
Arthrodesis type operations in children are used extremely rarely, since they cause a high level of trauma, and after them pain appears when walking.During hallux valgus surgery in children, doctors create a fixed connection between the talus and calcaneus, strengthening the muscles of the internal arch.
Consequences
It is very important to diagnose hallux valgus in time, because as the disease progresses, the musculoskeletal system will be increasingly affected.This results in the appearance of club feet, scoliosis and flat feet.It 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 shin level and have rigid arch support.Whether sandals or boots.
You need to purchase an insole for plano-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 gymnastics for the feet.It is prescribed by a doctor, but the simplest exercises are:
- walk inside and outside the foot, on the heel;
- pump a rolling pin or other round object with your feet;
- picking up objects and painting with toes;
- perform foot rotations.