Today, orthopedists diagnose flat feet in children very often.This deformity consists in 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 inner 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 is standing straight.
Valgus flatfoot in rare cases can be congenital, but more often it is a deformity that develops in children under 3 years of age.This foot position becomes apparent when the child takes its first steps.At this stage, parents should react and refer the child to an orthopedist.
shape
Valgus flat foot can be of two forms: congenital and acquired.Congenital deformity is diagnosed by doctors in the first month of life.This disorder develops during intrauterine development.Very often this happens due to genetic predisposition.
Congenital plano-valgus deformity can occur in very severe forms.For example, these are swing legs and vertical ram.Clubfoot develops more often in babies with Edwards syndrome.Vertical talus is a complex foot lesion, as its treatment requires surgery.Most often these are operations on the tendons in the form of their transplantation, lengthening or adjustment of the scaphoid bone, etc.But sometimes they pass only with a plaster cast.
With an acquired form of deformation, the structure of the leg changes under the influence of various factors.This usually happens due to a weak and not yet perfect tendon-ligament apparatus, etc.
reason
The main cause of valgus flat feet in children is the 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.Therefore, all the arches and arches of the foot develop incorrectly.
Factors that provoke flat foot valgus also include:
- rickets With this disease, the bone tissue becomes fragile and deformed;
- muscle paralysis.This could be after polio;
- association 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.Wearing shoes with flat, soft soles, without a strong back and foot 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 do any physical exercise.
Congenital flat feet often appear in babies born prematurely and when the child 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, shakes his legs and steps are unsteady.
- While walking, he steps mainly on the inside of the foot.
- Poor posture and a bent back always accompany leg deformities in children.
- The leg is shapeless and compressed.In the case of children, the leg appears healthy.
- 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.In the initial stage, the curvature does not exceed 150.Many children have this disorder, but it is corrected very easily and quickly, provided that the parents notice the problem in time.
In the second stage, the curvature of the leg reaches 200.This degree of damage requires longer treatment, but gives a positive result.
In 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 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.
Diagnosing
The diagnostic process begins with a visual examination of the child by an orthopedic doctor.Then, to determine the degree of deformity of the child's leg, the child is referred for other studies.Among them:
- X-rays - this study helps the doctor to accurately determine the presence of hallux valgus and the degree of its development.To do this, the picture was 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.
- In children, ultrasounds are performed to understand the condition of the joints and if there are other accompanying 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 is distributed on the leg.Plantography can also be performed with stress tests.
Orthopedics will refer the small patient for a consultation with a neurologist to accurately determine whether there is a disease of the central nervous system.Other specialists that will need to be visited are the surgeon and the endocrinologist.
Treatment
Treatment of valgus flat feet 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 stage, it will be enough for the child to wear the right orthopedic shoes and engage in physical exercises.There are special foot exercises that parents can do together with their child in a playful way so that he wants 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 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 performed in children's clinics.Paraffin wraps are made on the entire leg and stretch on the leg, like a high boot.After this procedure, you can start the massage.This will be quite effective, as the muscles soften after paraffin.
If a child has hallux valgus, then 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 in which the parents turned to the doctor was advanced, then surgical treatment is used.
Treatment of planovalgus foot deformity can be performed using the Dobbs method.This includes manual foot correction and plaster casting.About 6 procedures are required, which are performed at intervals of one week.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 stage of treatment for valgus flat feet, the doctor must adjust the talonavicular joint in the correct position.And for fixation, the doctor places a Kirschner wire, which is inserted through the skin.The cast should fix the leg for about 2 months.After that, a cast in the form of a boot is applied.Then the wires are recommended, that is, special shoes that have the desired shape.The child should wear them constantly and only after some time should they be worn during daytime and nighttime sleep.
Plano-valgus foot deformity can also be corrected using minimally invasive surgery.This changes the angle between the bones and, as a result, the tension of the ligaments increases.
Arthrodesis-type operations for children are extremely rarely used, as this results in a high level of trauma and is followed by pain when walking.During hallux valgus surgery in children, doctors create a fixed connection between the tailbone and the calcaneus, thereby strengthening the muscles of the inner arch.
The consequences
It is very important to diagnose hallux valgus at the right time, since as the disease progresses, the musculoskeletal system will be affected more and more.This is fraught with the appearance of flat feet, 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.
Preventing
To maintain the therapeutic effect of the therapy, the child must wear specialized orthopedic shoes.All shoes should reach the level of the foot and have a rigid arch support.Be it sandals or boots.
You should buy a plano-valgus foot insole, which can fit into any shoe.But only on condition that these are high shoes.
It is very important for the child, in addition to daily exercises and leading an active life, to do gymnastics for the legs.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 toes;
- performing leg rotations.