Hallux valgus in children is a serious anomaly that requires correction. Feet are not the only problem. Scoliosis, osteochondrosis are possible consequences of valgus.
What is hallux valgus?
Planovalgus deformity of the arch of the foot, or valgus, is an orthopedic pathology. Manifested by support in the medial part of the foot, curvature of the lower limbs in the standing position and while walking. In this case, the toes and heels are always turned outwards. In adults, valgus also occurs, but it appears differently. Bone deformity is manifested by a change in the position of the thumb. This condition is called a bone or lump in the finger.
The pathology arises from the deviation and elongation of the articular head of the metatarsal bone.
The first changes in the arch appear close to 1. 5 years. By the age of four, the deformity becomes apparent, as there is an incorrect positioning of the limbs when walking. The curvature of the legs is done like the letter "X". If the pathology is not corrected before school age, the child is threatened with flat feet and other problems of the musculoskeletal system.
According to its etiology, valgus is divided into congenital and acquired. Congenital disease occurs in the uterus, during the period of exposure to negative factors. It is diagnosed in the first 3-4 months after birth. Depending on the progression of the disease, several degrees of valgus are divided:
- I Art. - easier. The deflection angle is less than 15º. Correction requires wearing orthopedic shoes and physical therapy;
- Art II- averageThe deviation angle is less than 20º. Correction includes massage, physiotherapy, wearing special shoes;
- Art III- medium severity. The deflection angle is less than 30º. Pathology of this degree does not respond well to conservative therapy. Long-term treatment and ongoing rehabilitation are required to restore normal foot arch;
- Art IV- heavyThe deviation angle is more than 30º. To this degree, conservative therapy is ineffective. As a rule, surgical treatment and long-term rehabilitation are required.
A large number of cases of congenital valgus are severe. Therefore, it is important to identify the disease as soon as possible and start treatment in a timely manner.
Depending on the etiology of valgus, the following types of pathology are distinguished:
- Static posture - impaired;
- Structural causes - congenital. In pathology, the talus often deviates laterally;
- Corrective - due to improper therapy or lack of treatment of the stick feet;
- Compensator - steep slopes, Achilles tendon shortened;
- Spastic - nerve spasm of the extremities, as a result of dysfunction of the cerebral cortex;
- Paralytic - as a result of paresis caused by encephalitis or polio;
- Traumatic - fractures of the leg bones, injuries to the hip joints, ankle, ligament ruptures;
- Rickety - a consequence of rickets in children under one year of age.
Experts recommend adjusting the position of the legs up to 12-13 years. To understand how to correct orthopedic pathology in a child, it is necessary to diagnose and identify the cause of valgus development.
Causes of foot arch deformity
The cause of the congenital type of the disease lies in the violation of the intrauterine growth and development of the child. Under the influence of pathogenic factors, abnormal development of the legs occurs. One of the types of congenital deformities of the planovalg is a vertical ram. This is a common pathology that requires surgical treatment. Otherwise, the child is doomed to lameness in adulthood.
Acquired pathology appears due to other conditions:
- Lower limb trauma during childbirth;
- Changes in the foot, hip, knee or ankle after injury;
- Excess body weight - children's bone structures can not withstand the load;
- After transferred infections;
- Fibrous tissue dysplasia;
- Diseases of the nervous system;
- Endocrine pathology, for example, diabetes mellitus;
- Cerebral palsy.
Several factors can cause the development of hallux valgus:
- Unbalanced diet, lack of vitamins and proteins;
- Uncomfortable, soft shoes;
- The baby stood up early (up to 10 months);
- Parents strongly provoke standing and walking in children under 12 months;
- The lower limbs have been in a cast for a long time;
- The child often has a cold or flu.
Parents should be aware that genetics is also involved in the formation of the flat valve foot. Therefore, it is important for predisposed infants to perform pathology prevention. It is necessary to consult an orthopedist every year if there is a combination of heredity and other factors.
signs and symptoms
Subjective symptoms of valgus: fatigue from long walks, sometimes pain in the legs. But such signs are nonspecific. They occur with varus deformities or damage to the extremities. It is necessary to pay attention to the objective signs:
- When walking, the legs are placed incorrectly, more emphasis is placed on the inside;
- The lower extremities are swollen in the evening;
- Turn sideways when walking;
- Unstable gait;
- Shuffling feet;
- Spread your fingers;
- Difficulty joining heels
- The appearance of corns, calluses on the convex parts of the sole surface.
One of these signs or a combination of these should alert parents. Diagnosis It is necessary to tell the child to a traumatologist or orthopedist for diagnosis and treatment.
If hallux valgus is suspected, the baby should be seen by a pediatrician. The doctor will examine the lower extremities, take a medical history and, if necessary, refer to a specialist.
A traumatologist or orthopedist will determine the extent of the foot change. For diagnosis, the following instrumental examination methods are used:
- X-rays, photographs in three projections;
- Ultrasound of the ankle or other structures;
- Computer plantography - allows you to determine the detailed structure of the foot;
- Electromyography - allows you to assess muscle contractions;
- Podography - analyzes gait and its features.
Plantography can be done with the simplest method itself. To do this, you need to take a sheet of paper, put a special ink on it. After that, the foot should be firmly placed on the sheet. The trace determines the degree of deformation of the arch of the foot.
The greatest effect of conservative therapy is observed with insignificant deformity. How to correct a mild pathology:
- Wearing orthopedic shoes or beds - they are chosen by the doctor after carefully examining the feet;
- Taking multivitamin complexes;
- Home activities on ortho-carpets or stamped balls;
- General strengthening body massage with emphasis on the lower extremities;
- Baths with coniferous salt once a week.
Moderate deformation is corrected in the same way. Therapy includes medication: magnesium preparations, B vitamins, D. Parents are recommended to perform a variety of exercises and complex daily massages with their child at home.
Art III and IV. valgus requires long-term correction. Therapy includes:
- Wearing orthoses, braces, bandages;
- Drug therapy: analgesics, antihistamines, anti-inflammatory drugs, antimicrobials, venotonics and phleboprotectors, hormonal oils, drugs that improve the conduction of nerve impulses, muscle relaxants and others. The choice of medication depends on the patient's condition and the origin of the deformity;
- Massage. Performed by a certified specialist on a daily basis. Contributes to the normalization of muscle function, relieving soreness and spasticity;
- Physiotherapy procedures - achieving a positive therapeutic effect without unnecessary stress on the body. Electrophoresis with calcium preparations, paraffin therapy, darsonvalization, acupuncture, therapeutic baths, cryotherapy, mud applications are used;
- Physiotherapy. The choice of exercise depends on the etiology of the deformity. Complexes can be done both in the gym with an instructor and at home. The combination of home exercises and exercise therapy with a specialist allows you to achieve the maximum effect of recovery.
In the absence of results from conservative treatment, the doctor decides on surgery. Surgical interventions are aimed at restoring the function of the lower limbs or alleviating the condition. The following techniques are often used:
- Cutting tendons;
- Installing an external stack;
- Artificial ankylosis of the joints.
In particularly severe and neglected cases, they require removal of the damaged joint with its further replacement with an artificial one.
The main reason for the development of a foot defect in a child is the lack of proper attention to motor function. Parents should think about the health of the lower extremities from the first days of the baby's life. Preventive measures include:
- Balanced daily diet, lots of fruits, vegetables and protein;
- Daily walks in the fresh air;
- Healthy sleep;
- Comfortable casual shoes that meet international standards;
- Gymnastic exercises, exercises in fitball or ortho-mat;
- Drinking an aqueous solution of vitamin D;
- Daily fixing massages;
- Barefoot walking on stamped surfaces;
- Hardening by sun and water.
A common cause of valgus is early stress on the legs. You can not try to put the child on his feet or teach him to walk without his initiative. And annual consultations with a neurologist and a traumatologist will help identify and correct hallux valgus of the foot in children.