Today, orthopedists diagnose flatvalgus feet in children very often.This deformation 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, 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 up straight.
Valgus flatfoot can in rare cases be congenital, but more often it is a deformity that develops in children under 3 years of age.This position of the foot becomes noticeable when the baby takes his first steps.At this stage, parents should react and show the child to an orthopedist.
Forms
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.Quite often this occurs due to genetic predisposition.
Congenital plano-valgus deformity can occur in very severe forms.For example, these are the rocker foot and the vertical ram.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 operations on tendons in the form of their transplantation, lengthening, or adjustment of the scaphoid bone, etc.But sometimes they get by 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 valgus flatfoot 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.Accordingly, all the arches and arches of the foot develop incorrectly.
Factors that provoke valgus flatfoot also include:
- rickets.With this disease, bone tissue becomes fragile and deformed;
- muscle paralysis.This may be 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, excess weight 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 the child.Wearing shoes with flat, soft soles, without a hard back and instep support is contraindicated.Especially for children under 3-5 years old.
The risk group also includes children who lead a sedentary lifestyle if the child does not perform any physical exercise.
Flat-valgus feet of the congenital type often appear in premature babies, and in the case when 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 awkwardly, shuffles his feet, and steps are unsteady.
- When walking, he mainly steps on the inner part of the foot.
- Poor posture and stooped back always accompany foot deformities in children.
- The foot is shapeless and compacted.In the case of children, the foot appears plump.
- X-shaped legs.
Parents may also notice other symptoms in their child:
- tired legs and may experience 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 have this disorder, but it is very easily and quickly corrected, 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 it gives a positive result.
At the third stage, it is necessary to treat flat-valgus feet in children in a comprehensive manner, 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 more 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 orthopedic doctor.Next, to determine the degree of deformation of the child’s foot, the child is referred for other studies.Among them:
- X-ray – this study helps the doctor accurately determine the presence of hallux valgus and the degree of its development.To do this, the picture 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 condition of the joints and whether there are any other concomitant diseases.
- Computed plantography is a study in which the feet are scanned on a specialized platform.The computer is able to determine 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 visited are a surgeon and an endocrinologist.
Treatment
Treatment of flat-valgus 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.At the first stage, it will be enough for the child to wear the correct orthopedic shoes and engage in physical exercise.There are special gymnastics for the feet that parents can perform together with their child in a playful way so that he wants to be treated.Sometimes at this stage a course of therapeutic massage is also prescribed.Such treatment measures help strengthen muscles and ligaments locally.
Conservative treatment for other stages of flat-valgus foot 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 wraps are done on the entire foot and extending onto the shin, like a high boot.After this procedure, you can begin the massage.This will be quite effective, since the muscles are softened after paraffin.
If a child has hallux valgus, then therapeutic massage should only be performed by a qualified specialist.You can do it at home if a specialist has given permission and instructed your parents.
Surgical treatment
If all methods of conservative treatment do not have an effect or the stage at which the parents turned to the doctor was advanced, then surgical treatment is used.
Treatment of planovalgus foot deformity can be carried out using the Dobbs method.This involves manual correction of the feet and plaster casting.About 6 procedures are required, which are carried out at intervals of one week.After each week, the position of the foot during casting changes.The cast begins from the middle of the thigh, the leg is bent at the knee.At the end of this stage of treatment for flat valgus feet, the doctor must fix the talonavicular joint in the correct position.And for fastening, 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 plaster cast is applied in the form of a boot.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 put on during daytime and nighttime sleep.
Plano-valgus foot deformity can also be corrected using minimally invasive surgeries.This changes the angle between the bones and, as a result, the tension of the ligaments increases.
Arthrodesis-type operations for children are used extremely rarely, since this results in a high level of traumatism, and after them there is pain during walking.During surgery on hallux valgus in children, doctors create a fixed connection between the talus and 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 a rigid arch support.Be it 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 these 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:
- walking on the inside and outside of the foot, on the heel;
- pumping a rolling pin or other round object with your feet;
- picking up objects and painting with your toes;
- performing foot rotations.