Today, orthopedists diagnose valgus flat feet in children very often.This deformation consists of the sinking of the inner part of the foot.In other words, the straight axis that goes from the 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 flat 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 upright.
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 foot position becomes noticeable when the baby takes his first steps.At this stage, parents must react and show the child to the orthopedist.
Forms
Valgus flat foot can be of two forms: congenital and acquired.The congenital deformity is diagnosed by doctors in the first month of life.This disorder develops during intrauterine development.This often occurs due to genetic predisposition.
Congenital planovalgus deformity can occur in very severe forms.For example, these are the swing foot and the vertical ram.Wobble foot develops more often in babies with Edwards syndrome.Vertical talus is a complex foot injury, as 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 survive with just plaster.
With an acquired form of deformity, the structure of the foot changes under the influence of various factors.This often occurs due to a weak and not yet perfect tendon-ligamentous 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.Consequently, all arches and arches of the foot develop incorrectly.
Factors that provoke valgus flat feet also include:
- rickets With this disease, bone tissue becomes fragile and deformed;
- muscle paralysis.This can happen after polio;
- concomitant with other serious diseases – cerebral palsy (CP), polyneuropathy, muscular dystrophy;
- chronic disease of an infectious or viral nature that contributes to circulatory problems;
- traumatic foot and leg injuries;
- various dysfunctions of the endocrine system.For example, being 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 selected shoes for the child.It is contraindicated to wear shoes with flat, soft soles, without a hard back and support for the instep.Especially for children under 3 to 5 years old.
The risk group also includes children who lead a sedentary lifestyle if they do not practice any physical exercise.
Congenital valgus flat feet usually appear in premature babies and in case the child is underweight in the womb.
Signs and symptoms
The visible signs of this foot deformity in a child are:
- Gear changes.The child walks awkwardly, drags his feet and steps are unsteady.
- When walking, he steps mainly on the inside of the foot.
- Poor posture and a hunched back always accompany children's foot deformities.
- The foot is misshapen and compacted.In the case of children, the foot appears plump.
- X-shaped legs.
Parents may also notice other symptoms in their children:
- tired legs and may feel pain at the end of the day;
- headache;
- back pain.
Degree of damage
There are 4 main stages of plano valgus foot deformity.In the initial phase, the curvature does not exceed 150.Many children have this disorder, but it is corrected very easily and quickly, as long as the parents notice the problem in time.
In the second stage, the curvature of the foot reaches 200.This degree of damage requires longer treatment, but 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 stage deviates 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.
Diagnosis
The diagnostic process begins with a visual examination of the child by an orthopedist.Next, to determine the degree of deformation of the child's foot, the child is sent for 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 computational diagnosis used when a deformity is suspected if it is difficult to diagnose visually.That is, the signals are not expressed.
- Ultrasounds 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 several morphological parameters.In this case, the doctor will understand how the load is distributed on the foot.Plantography can also be performed with stress tests.
The orthopedist will refer the little patient to 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 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 degree of damage.The main goal of therapy is to restore the normal position of the foot.In the first phase, the child will only need to wear the correct orthopedic shoes and practice physical exercises.There are special gymnastics for the feet that parents can do together with their child in a playful way so that they want to be treated.Sometimes at this stage a course of therapeutic massage is also prescribed.These treatment measures help to strengthen muscles and ligaments locally.
Conservative treatment for other stages of flat valgus foot in a child consists of paraffin, therapeutic massage and gymnastics.They also use physical therapy in the form of electrophoresis, magnetic or electrical muscle stimulation.
Paraffin waxing is carried out in children's clinics.Paraffin wraps are made over the entire foot and extend to the shin, like a high boot.After this procedure, you can start the massage.This will be quite effective as the muscles are softened after paraffin.
If a child has hallux valgus, therapeutic massage should only be performed by a qualified specialist.You can do this at home if a specialist has authorized and instructed your parents.
Surgical treatment
If all conservative treatment methods 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 foot correction and plaster casting.Approximately 6 procedures are required, performed at intervals of one week.After each week, the foot position during throwing changes.The cast starts from the middle of the thigh, the leg is bent at the knee.At the end of this stage of the treatment of flat valgus foot, 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 hold the leg in place for about 2 months.Then a boot-shaped plaster is applied.Then, suspenders are recommended, that is, special shoes that have the desired shape.The child must wear them constantly and only after some time should they be put on during day and night sleep.
Plano-valgus foot deformity can also be corrected through minimally invasive surgery.This changes the angle between the bones and, as a result, the tension on the ligaments increases.
Arthrodesis-type operations in children are extremely rarely used, as they result in a high level of trauma and, after them, there is pain when walking.During hallux valgus surgery in children, doctors create a fixed connection between the talus and the calcaneus, thereby strengthening the internal arch muscles.
Consequences
It is very important to diagnose hallux valgus in a timely manner, as 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 must reach shin level and have rigid arch support.Whether sandals or boots.
It is necessary to purchase an insole for planovalgus feet, which can be inserted into any shoe.But only on condition that they are high shoes.
It is very important that the child, in addition to doing daily exercise and leading an active lifestyle, does foot gymnastics.It is prescribed by a doctor, but the simplest exercises are:
- walking on the inside and outside of the foot, on the heel;
- pump a roller or other round object with your feet;
- pick up objects and paint with your toes;
- performing rotations of the feet.