Incorrect position of the foot in children. Treatment for flat-valgus foot in a child

Valgus flatfoot experts consider the most common pathology among children's orthopedic diseases. Most often, hallux valgus in children is diagnosed as soon as he takes his first steps. Such a disease is characterized by the incorrect location of the baby's feet relative to each other, when walking, the emphasis is on their inner side.

A congenital disease can be determined at the first examination by an orthopedist of a child, even in the maternity hospital. In young children, there is a small layer of fat on the foot, so at this age the pathology of foot development is also not visible. It is possible to speak confidently about the presence, absence of such a pathology when the child's skeleton is fully formed, by about 6 years.

Causes

It is quite difficult to determine the hallux valgus deformity of the foot in children under two years old from the photo. Deviations of this kind are considered by experts to be the norm at this age. It is also necessary to take into account the similarity of this disease with clubfoot.

The causes of its occurrence may be identical to flat feet, but the treatment will require a completely different one.

The main factor in the appearance of valgus flat feet in a child is heredity.

If one of the parents suffered from such a disease, then with a high probability it will appear in his children.

Flat valgus curvature of the feet can also develop along the following reasons:

  • Overweight mothers and severe obesity during pregnancy;
  • Wearing uncomfortable shoes;
  • Joint hypermobility;
  • Foot injuries;
  • Violation of motor functions;
  • endocrine diseases;
  • Violation of calcium metabolism, as well as other useful substances in the body;
  • Lack of vitamin D;
  • The presence of cerebral palsy, polio and other diseases that cause paralysis of the lower extremities.

Varieties of pathology

The appearance of a flat valgus foot in a child can be a congenital and acquired disease. In the first case, the foot can already be deformed in the womb along with the formation of the child's skeleton.

The acquired form of the disease is the result of a negative effect on the body of one or more negative factors. The nature of the deformity of the valgus foot in a child may be different.

There are three following types of valgus pathology:

  • Transverse. The main signs of such a pathology can be called a noticeably expanded forefoot. The muscles and tendons responsible for finger extension are in tension. The child complains of pulling pain.
  • Longitudinal. You can determine such a pathology by a violation of gait, a change in the shape of the foot, when probing which the baby feels severe pain. The child cannot stay on his feet for a long time, as the wrong position of the feet causes discomfort.
  • Combined. This type of flat feet has all the signs of the disease, but they are rarely accompanied by pain. Deformation of the feet of the combined type does not cause any inconvenience to the child.

Below you can see photos of hallux valgus deformity in children:



Degrees of development

Valgus flat feet can have four degrees of development. Each form of the disease is characterized by a particular course of the disease. Methods of diagnosis and treatment in each case will also be different.

The valgus position of the leg develops in stages:

1 stage. The initial stage of the disease is quite easily and quickly diagnosed and treated. The foot in the first stage of valgus flatfoot is flat, with a slight deviation (15°.)

2 stage. At this stage, the deviation of the foot by 20° is observed. Treatment of the disease will be lengthy, but with maximum effort and resorting to various methods, a complete recovery is possible.

Z stage. It will be quite difficult to eliminate the deformity of the foot with a deviation of up to 30 °. The therapy must be necessarily complex using massage, traditional methods of treatment, and it will also be necessary prolonged wear orthopedic shoes.

4 stage. This form of hallux valgus is the most severe. With flat feet of the 4th stage, the child's foot is located flat, and the angle of deviation exceeds 30 °.

Complex treatment in this case is unlikely to show a positive result. The only option to get rid of foot deformity is surgery.

Symptoms

The curvature of the valgus of the foot does not occur suddenly, but develops over a fairly long period, so the chances of recovery are quite high. Successful treatment of valgus flatfoot depends on timely and accurate diagnosis. The sooner parents notice a deformity of the sole in their baby, the easier and faster the therapy will be. The following symptoms should be the reason for visiting an orthopedist:

  • The child complains at the end of the day of a pulling pain in the legs;
  • Unsteady gait, waddling from side to side;
  • The presence of corns and corns on the soles;
  • The fingers are constantly spread apart, not clenched together;
  • Complaints of the child about uncomfortable shoes, due to the width and other features of the sole.

Therapy Methods

It is necessary to treat hallux valgus by several methods. Only with such an integrated approach can we hope for a good result. Absolutely all therapeutic techniques are aimed at normalizing the shape of the foot and getting rid of unpleasant symptoms.

The most effective and affordable methods of treating valgus flat feet are: massage, exercise, wearing specially made shoes. Electrophoresis, waxing, acupuncture and foot baths are also often used.

Massage

This method of treatment of valgus flatfoot in children is quite effective. Sessions are carried out in conjunction with other procedures that strengthen the body. In addition to foot massage, attention should be paid to the lower back, since it is here that the branching of the nerve endings that go to the muscles of the legs occurs.

For a massage with a valgus foot, it is necessary to lay the patient on his stomach and place a special roller under the feet. Using a tong-like grip, the sole should be well rubbed and kneaded, massaging rhythmically.

Therapeutic foot massage for flat valgus perfectly stabilizes muscle tone, relieves tension, strengthens muscle tissue.

Also, thanks to the massage, blood circulation improves, tissues and ligaments are enriched with oxygen, which normalizes the development of the legs.

The procedure will be more effective if the massage for hallux valgus in children and other types of flat feet is supplemented by the following specially designed exercises:

  • Flexion and extension of the sole;
  • Finger wiggling;
  • Capturing and holding a ball or toy with the sole;
  • Rotation of the leg.

It should always be remembered that a massage with a flat valgus foot is the easiest option for business treatment.

Physiotherapy

Carrying out therapeutic and gymnastic procedures is a mandatory measure in the treatment of valgus flatfoot. Exercises should be performed barefoot or in thin socks. The complex of such measures is aimed at getting used to the foot to be in the correct position, especially when walking.

Taking the first steps, the child, in order to increase his area of ​​\u200b\u200bsupport, places his feet very widely. Up to three years, such a gait is considered the norm, and in the future, a correct and stable setting of the feet is developed.

The best exercise for hallux valgus, aimed at developing the correct walking skills, experts consider walking along a kind of narrow path. Its width should not exceed 15 centimeters.

You can use a long board, a drawing on a carpet, or just draw two parallel lines with chalk on the floor. The child must be offered to go all the way without stepping outside the aisles of the track.

Children with a disease of curved valgus feet are shown exercises on the Swedish wall, as well as swimming. Conducting water procedures has a positive effect on the entire body of the child, improves metabolism, improves immunity.

Jumping on a corrugated orthopedic rug in the bathroom will also have a positive effect. Children are happy to do gymnastics while swimming on a special surface, as the exercises become easy to perform, as the water relieves the excess load and the leg moves freely.

Orthopedic shoes

Shoes, sandals for a child with valgus, and not only, flat feet should be selected more than thoroughly. They must be made of a sufficiently rigid material to keep the foot and heel in the correct horizontal position.

The size of orthopedic shoes should be selected based on the length of the child's foot. The sole should be slightly (1 cm) longer than the leg itself. A small wide heel is also required.

Children with congenital pathology of valgus of the foot are strictly forbidden to wear shoes with soft, flat soles without backs (slip-ons, felt boots, rubber boots, etc.). It is also not recommended to wear someone else's shoes, as this will only harm fragile children's legs.

Prevention

Taking care of the health of the baby should begin even before his birth. Proper management of pregnancy will prevent the appearance of congenital pathologies in the child, as well as protect against diseases acquired in the future. A woman in anticipation of a child should eat right, move enough and follow all the doctor's prescriptions.

If the baby at birth has a suspicion of a valgus foot, then up to 8 months it is necessary to limit the load on the baby's fragile legs. It is also very important to observe the following rules for the prevention of the formation of valgus disease:

  • Do not overload the muscles of the child's legs, especially at an early age (up to 12 months);
  • Regularly carry out affordable prevention of rickets and other diseases;
  • Increase the tone of the leg muscles with the help of gymnastic exercises;
  • Wear only high-quality shoes made of hard materials;
  • Increase immunity, avoid viral diseases.

In children, valgus flatfoot responds well to treatment if such a pathology is detected on early stage. By establishing a diagnosis in time and starting complex therapy, you can count on a complete quick recovery.

Only an experienced doctor in this field knows how to treat such a disease, so it is better not to self-medicate. If flat valgus deformity of the feet is significant, then surgery is indicated to treat the curvature.

Yes, the flat-valgus problem is very well considered in the well-known video program. We recommend viewing:

Almost a year passes from the exciting moment of the birth of a baby to the first, very important steps in life. The crumbs at first walk awkwardly and waddling. With the build-up of walking skills, almost everyone's gait improves, but there are cases when a child continues to walk, stepping mainly on the inner surface of the foot - this is a valgus foot - a defect that can complicate the life of a little man. This negative moment will be discussed today.

Mommy's happiness is taking hard first steps with concentration.

Feet in an X

What is flat valgus foot deformity?

This is a curvature inward (towards the center of the body) of an initially straight axis from the lower leg to the foot, accompanied by a decrease in the height of the arches of the foot itself and the deviation of the heel and toes outward (looks like butterfly wings from behind). The average longitudinal inner arch of the foot (the hollow between the heel and toes) practically disappears. When squeezing and straightening the baby's knees, the distance between the inner surfaces of the ankles is more than 4 centimeters. If you put the child on the legs, then a distinctly pathological letter “X” looms between the feet.

This X-shaped position of the feet relative to each other is called "plano-valgus deformity of the feet."

It is not difficult to determine the diagnosis: the baby's feet will be located at a certain angle.

The root of the problem

What are the reasons for the development of this disease? Valgus foot in children can be:


Factors affecting the development of the disease

The prerequisites for the occurrence and development of acquired hallux valgus can be:


Visible signs of hallux valgus

The most obvious symptoms of the defect are visible when the baby is walking:

  • the child does not step on the entire surface of the foot, but only on its inner edge;
  • X-shaped form of the foot itself;
  • clumsy gait;
  • uncertainty of steps;
  • shuffling;
  • fatigue from walking.

The little man walks courageously, overcoming fatigue.

These symptoms, except for the first two, can be found in all children starting their first journeys on their own legs. As the baby acquires the skills necessary for walking, the symptoms will disappear. Another thing is if the child has been walking for a long time, and these last 4 symptoms appear. There is no point in panicking, but it is necessary to seek clarification of the causes of such pathological manifestations from a doctor.

The degree of development and severity of the disease

The doctor, depending on the degree of deformation and the severity of the pathology, will determine the severity of the disease:

  • the degree of deviation ranges from 10-15 0 - a well treatable degree;
  • deviations from the norm by 15-20 0 - treatment will require some effort;
  • the angle of deviation from the norm varies from 20 to 30 0 - the treatment will be long;
  • more than 30 0 - long-term treatment. If complex therapeutic treatment is ineffective, surgical removal of the foot defect can be performed.

Any degree of the disease can be successfully eliminated.

Often, babies with a diagnosis of "flat-valgus foot" develop flat feet. In later childhood, the consequences of a valgus defect include osteochondrosis, arthrosis, scoliosis, various deformities of the pelvic, knee and ankle regions. Less commonly, one of the limbs is shortened. Clubfoot develops with varus deformity of the foot - in the opposite direction from the valgus.

What and how to treat?

Treatment for a small patient can only be prescribed by a professional doctor. To get rid of a congenital valgus foot, fixing plaster bandages, splints or splints are used. A pediatric orthopedist can and should choose a fixing element. It takes into account the individual characteristics of the development of a defect in a child and, based on:

  • podometry- a method that allows to detect pathological changes in case of an unclear situation;
  • ultrasound;
  • radiography- X-ray in 3 different projections (it is done very rarely for small children);
  • computer plantography- studies of the morphological parameters of the foot;
  • visible external signs - appoints procedures restoring the normal functioning of the foot and individual fixation of the limbs.

The outcome of numerous studies will enable the orthopedist to direct the treatment in the right direction.


Treatment of an acquired valgus foot defect is usually carried out in a complex way:
  • foot baths;
  • paraffin therapy (wax wrap);
  • ozocerite and mud applications;
  • electrophoresis;
  • magnetic therapy;
  • electrical stimulation of the muscles of the foot and lower leg;
  • therapeutic swimming;
  • IRT - acupuncture;
  • LFK - physiotherapy exercises.

There are a variety of ways to get rid of the disease.

Also, as in congenital pathology, orthopedic splints, plaster casts and other fixing elements are widely used to treat acquired valgus foot.

Benefits of massage

Massage with a flat-valgus foot, due to its effectiveness, occupies a special place among all technologies to combat the disease. It regulates the tone of the muscles of the lower leg and foot, relieves excessive tension and makes the muscles stronger, more elastic and resilient, improves blood circulation. An increase in the latter contributes to the normalization of the development and growth of the legs. To help the baby get rid of the valgus foot - you need to massage:

  1. back,
  2. lumbar region,
  3. gluteal region,
  4. joints and muscles of the legs,
  5. Feet.

It is necessary to pay attention not only to problem areas.

Before starting the massage, the baby must first be laid on the tummy so that his feet hang from the edge of the massage or changing table, and put a small pillow in the form of a roller under the shins.

We begin to massage the back with strokes along the spine. We stroke the baby from the waist to the side of the neck. Gradually increasing the distance between our hands, we stroke the entire back to the sides and armpits. From stroking, we move on to light rubbing. We hold them with our fingertips over the entire surface of the baby's back. After we bend our fingers so that their tips touch the palms, and make rubbing movements with the resulting combs. One hand moves in one direction, the other in the opposite direction, as if sawing. Finish the back massage with stroking.

Let's start therapy from the back of the crumbs.

It is necessary to massage the lumbosacral region by alternating stroking and rubbing. We put a little baby cream on our hands (if the baby is not allergic to it) and begin to stroke his lower back in the direction from the spine in different directions and at the same time down. In the same direction, we carry out rubbing.

On the gluteal region we make circular and crosswise strokes. We rub the baby with the backs of the fingers, knead his muscles, patting, gently tapping the buttocks of the crumbs. We finish the massage with strokes.

From the ass of the crumbs we move to main goal Events.

We massage small legs in the sequence:

  1. stroking all the legs completely;
  2. stroke the hips from the dimples under the knees up and out;
  3. knead the muscles of the entire back surface of the leg with a little pressure;
  4. rub the skin;
  5. alternate patting the baby's legs with the palm of your hand with closed and open fingers;
  6. we carry out the final stroke.

Carefully work on the child's legs, using all the methods presented.

The massage of the legs may vary depending on the condition of the muscles of the crumbs. We begin the general massage with light strokes that promote blood flow to the part of the body we need. It is necessary to iron the child from the heel to the popliteal dimple. It is not necessary to knead and rub the outer side of the lower leg strongly. Here it is better to focus on relaxing techniques: stretching, stroking and shaking. The inner part of the calf muscle, on the contrary, must be vigorously rubbed with the back of the fingers. We make kneading movements with fingertips. Here you need to apply force. After deep kneading, we perform tapping and “chopping” the inside of the lower leg with our fingers. We complete the massage of the legs with strokes.

With gentle strokes, we soothe the heated skin of the baby.

After all the actions performed, we turn the baby on its back and make a set of massage movements on the front surface of the thigh:

  1. stroking;
  2. rub;
  3. knead;
  4. shake;
  5. stroking.

By changing the position of the crumbs, we switch attention to his hips.

Everything actions are performed from the bottom up and outwards. We massage the front surface of the lower leg from the foot to the knee in the same way as with the front surface of the thigh.

Now you can turn the baby on the tummy.

Moms, do not tremble, you are doing everything right.

We begin foot massage by giving the legs the desired position - the soles look inward. First we stroke one of the feet, then vigorously rub it. We perform the same actions with the other foot. We pay special attention to the notch between the heel and toes of the baby. We actively rub it and knead it, pinch it. The upper part of the foot is also stroked and rubbed with a little pressure. Before massaging the upper part of the baby's foot, you need to turn it on its back. Massage separately in circular motions. thumb and a foot beside him on each leg.

If you are worried that you will not be able to cope with the massage yourself, then it is better to use the services of a professional children's masseur or invite him to control your actions.

Such necessary exercises

The strengthening effect of massage can be enhanced by special exercises:

  • turning the feet with the soles inward;
  • flexion of the back of the foot;
  • flexion of the soles;
  • flexion of the toes;
  • turning the feet inward with the capture and retention of the toy by them;
  • foot rotation.

We motivate the child from childhood to do light gymnastics in the morning.

The above exercises must be performed in a complex manner. At first, you and your baby will do them, and when the baby grows up, he will be able to perform healing movements himself.

Pleasant and useful gymnastics

Along with massage and special exercises therapeutic exercises help to eliminate the pathology. There is a whole gymnastic set of exercises for children who already know how to stand.

Baths with a corrugated surface are a good leg workout.

The easiest and most enjoyable exercise to perform is jumping and walking on a small corrugated rug spread at the bottom of the tub. The exercise perfectly strengthens the baby's feet, without creating an excessive load on the child's still fragile bone joints. It is necessary to carry out a gymnastic complex several times a day. Recommendations on which exercises are best to use for the treatment of hallux valgus in your baby should be given by a pediatric orthopedist.

It is also necessary to attend all physiotherapy procedures prescribed by the doctor and not to self-medicate the baby.

“A few months ago, my baby, who was then 10 months old, was diagnosed with hallux valgus. They prescribed a massage, ozocerite and amplipulse baths, and ordered me to wear shoes. We've been dealing with this issue for 5 months now. There are shifts in better side. Massage combined with physiotherapy gives a very good effect! Don't neglect these treatments!"

Proper footwear in treatment is very important

A child with an incorrect foot position must definitely wear special, individually selected orthopedic shoes. The peculiarity of the latter lies in the presence of rigid lateral fixators of the feet and heels, insoles, individually selected functional insoles, and a small wide heel. Parents themselves should not choose such shoes - this should be done by a knowledgeable specialist. He is also obliged to tell about the duration of wearing corrective shoes (you can’t wear them all the time - muscles can atrophy). Doctors recommend even a healthy baby to wear orthopedic shoes, starting from the first steps.

To walk or not to walk barefoot?

The well-known pediatrician E. O. Komarovsky advocates walking at home with a valgus foot barefoot: “This has a positive effect not only as a hardening procedure, but also as an aid in the formation of the foot,” he says. Only the surfaces on which the child walks should not be smooth and absolutely even. The practice of walking barefoot or in thin socks is used when performing therapeutic exercises.

Walking barefoot is an important aspect that parents should not miss.

Elina supports Evgeny Olegovich:

“With the diagnosis of flat-valgus planting of feet, the orthopedist prescribed walking in special shoes that tightly fix the ankle joint, but we refused to walk in such shoes because my daughter experienced discomfort and began to act up only at the mere sight of these shoes. We didn’t have too much weight and, in addition, we trained a lot with her to stand and walk barefoot at the support. So we decided: orthopedic shoes are not for us. Now there are significant improvements, but I believe that the difficult question of whether it is possible to do without hard shoes or not should be decided individually for each child in dialogue with an orthopedist.”

We prevent the occurrence and development of the disease

How can you avoid the appearance of an acquired flat-valgus foot in a child? Defect prevention is reduced to the following measures:

  • do not put the baby on legs before 7-8 months;
  • carry out daily hardening;
  • do exercises that strengthen muscles and ligaments;
  • carry out preventive massage;
  • give the child complete food;
  • follow a diet with HB;
  • walk daily with the baby;
  • give the baby anti-rachitic vitamin D;
  • choose high-quality and appropriate shoes for the size of the baby’s legs;
  • time to visit doctors-specialists.

Be sure to make a long, daily exercise with the crumbs.

Up to 7 years, a flat-valgus foot can be completely cured. Up to 12-13 years - just slow down and adjust the process. Later treatment is practically useless.

According to statistics, almost every child under 5 years of age who has deviations in the development of the feet (40-80%) also has a diagnosis of plano-valgus deformity of the feet. It is accompanied by the following deviations:

  • flattening of the longitudinal arch;
  • valgus position of the posterior section;
  • abduction-pronation position of the anterior section.

The maximum percentage is observed in children of primary school and preschool age. Although there are times when this diagnosis can be considered unauthorized.

The shape of the foot, formed in the course of evolution, provides an even distribution of body weight. The bones of the foot, connected by strong interosseous ligaments, form its arch, the role of which is to provide maximum cushioning of movements when running and walking. Convex arches are oriented in two directions - transverse and longitudinal. Therefore, normally, the foot of an adult has three points of support - the head of the first metatarsal bone, the calcaneal tubercle and the fifth metatarsal bone.

In children, flattening of the arch of the foot, as a rule, occurs during the period when the baby is just taking the first steps; this is due to quite serious loads on the legs when trying to take a step. Of course, you can’t expect a perfectly correct foot placement or hip-to-hip gait from a baby right after he first got on his feet. You should not panic or immediately put an end to a sports or military career.

As a rule, the first complaints of parents arise when the child takes the first independent steps. In this case, it is necessary to clearly distinguish between the physiological flattening of the arch of the foot of a child who has not yet reached the age of three years, and the flat-valgus deformity itself, which already requires the supervision of an orthopedist. Up to three years of age, children have a “fat pad” on the plantar aspect of the foot, so the arch of the foot is not visible with a simple visual inspection. But it will be noticeable if you ask the baby to stand on his toes. Bone tissue in a child continues to form up to 5-6 years, so only during this period it makes sense to start talking about the absence or presence of a flat-valgus DEFORMATION in a baby as such.

Although it should be borne in mind that flat-valgus feet in children can lead to such negative consequences as:

  • severe curvature of the spine;
  • constant pain in the legs;
  • "adult" diseases - osteochondrosis, arthrosis.

In some cases, the diagnosis of "valgus feet" is made to the child in the hospital. In this case, the congenital nature of the disease (vertical ram) takes place.

Causes of foot deformity

1. Connective tissue dysplasia (78%). Polluted water and air, poor quality food lead to the fact that the connective tissue, which is the basis of the ligamentous apparatus of the joints (as well as all other organs), is formed incorrectly.

2. Incorrect children's shoes (soft models with flat soles that do not properly fix the foot).

3. The kid is not engaged physical culture in preschools and in the family.

4. Genetic and endocrine (diabetes, diseases thyroid gland) violations.

5. Osteoporosis (damage to the bones of the skeleton).

6. Various foot injuries.

Doctors identify a number of theories that can be used to explain the etiopathogenetic mechanisms:

  • anatomical theory;
  • vestimentary theory;
  • static-mechanical theory;
  • theory of hereditary muscle weakness;
  • theory of constitutional weakness of the connective tissue.

Classification:

  • hypercorrection in the treatment of clubfoot;
  • congenital;
  • paralytic;
  • rickets;
  • traumatic;
  • static.

Doctors distinguish three degrees of severity of flat-valgus deformity of the feet: mild, moderate and severe. The so-called rocking foot (vertical ram, paperweight foot) is the most severe degree of deformity. It is detected immediately at birth, the incidence of detection is 1 per 10,000 newborns. The etiopathogenesis of this deformity has not yet been fully elucidated. As the most likely cause of the deformity, doctors single out a malformation of the germ and a delay in its development at one of the stages of embryo formation.

Foot parameters are normal:

  • if you draw two lines - along the lower contour of the calcaneus and the first metatarsal bone - so that the top of the angle is in the region of the scaphoid, this angle should be 125 °;
  • height of the longitudinal arch - 39-40 mm;
  • valgus position of the hindfoot - from 5 to 7 °;
  • the angle of inclination of the calcaneus relative to the plane of support is from 20 to 25°.

The height of the longitudinal arch of the foot in preschool children can normally be 19-24 mm.

Light degree is characterized by the following parameters:

  • the height of the longitudinal arch of the foot is reduced to 15-20 mm;
  • vault height angle reduced to 140°;
  • the angle of inclination of the calcaneus - up to 15°;
  • valgus position of the posterior section - up to 10 °;
  • abduction of the forefoot (8-10°).

Average degree:

  • the arch of the foot is reduced to 10 mm;
  • vault height reduced to 150-160°;
  • the angle of the calcaneus up to 10°;
  • valgus position of the posterior section and abduction of the anterior section - up to 15 °.

Severe degree:

  • the arch of the foot is reduced to 0-5 mm;
  • the angle of height of the arch of the foot is reduced to 160-180°;
  • the angle of inclination of the calcaneus - 5-0°;
  • valgus position of the posterior section and abduction of the anterior section - more than 20 °;
  • severe deformity is rigid and cannot be corrected;
  • constant pain syndrome in the region of the Choparov joint.

The foot is the foundation, the "foundation" of our body. And if the foundation is curved, then even, secure home do not build on it. Plano-valgus deformity of the feet entails valgus (X-shaped) deformity of the knee and ankle joints, incorrect position of the pelvis, and posture disorders. The curvature of the axes of the spine and limbs leads to an overload of the muscles, which will unsuccessfully try to keep the body in the correct position. As a result - the appearance of pain, the early development of arthrosis, osteochondrosis.

Prevention:

  1. Loading the baby's legs before 7-8 months is not worth it. As an element of gymnastics, you can attach a baby earlier, but only for a short time and always with support.
  2. Prevent rickets.
  3. The kid should wear the right shoes: having a hard high back (3-4 cm above the heel), which helps to keep the heel on the axis of the lower leg, as well as a flexible sole and a small arch support.
  4. Be sure to undergo examinations by an orthopedist (1, 3 and 6 months of life, a year and three, from 4 years old - annual visits).

Treatment

In view of all of the above, parents need to understand that flat feet are a serious problem only when the feet are not just flat, but also cause discomfort to the baby when walking or running. If, when lifting on toes, the arches of the feet of the baby look normal and do not bother him in any way, then treatment is not required.

If flat feet are also painful, rigid (stiff) - this is a completely different situation. Here, the help of an orthopedist who regularly deals with the feet is already needed in order to correctly assess the severity of the pathology and develop adequate tactics for managing the patient. It can be either orthotics with the help of specialized shoes, or surgical treatment in various options:

1. Grice's operation (subtalar arthroeresis).

Before treatment After treatment

2. The Dobbs method for the treatment of a vertical ram (staged plastering followed by percutaneous fixation with a Kirschner wire).

The Dobbs method consists in conducting 5-6 sessions (one per week) of gentle manual correction of foot deformity. Each session ends with a cast of the involved lower extremities, aimed at securely holding the feet in the position of the maximum possible correction. In this case, a plaster cast is applied from the upper third of the thigh to the fingertips with the knee joint bent to 90°.

Soft tissues in children are sufficiently extensible, which allows, from session to session, gradually, without anesthesia, to eliminate dorsiflexion, pronation and abduction of the forefoot and bring them into the position of supination, varus and plantoflexion. For 5-6 sessions, clinical and radiographically, the anatomical relationships in the joints of the middle and hindfoot are normalized. The last stage consists of two surgical manipulations: fixation of the talonavicular joint with a Kirschner wire in the correct position (percutaneously, under the control of the image intensifier) ​​and complete percutaneous achillotomy.

After these manipulations, a plaster cast is applied for up to 8 weeks. After the needles are removed, the child is in plaster boots (without fixing the knee joint; with a longitudinal arch laid out; with the possibility of full support on the legs). Then, in order to prevent recurrence of foot deformities, up to the age of 4, babies are prescribed an orthopedic regimen of wearing braces. As after the Ponseti treatment, children wear brace at the first stage 23 hours a day (for 4 months), then the wearing time is gradually reduced, and later the brace is worn only during sleep (night and daytime). The difference from the Ponseti method is only in the angular settings of the foot abduction. In the future, children treated according to the Dobbs method wear orthopedic shoes with a longitudinal arch.

3. Various soft tissue and arthrodesis surgeries.

It must be understood that when making a diagnosis and treatment, all the nuances must be coordinated with both an orthopedist and doctors of related specialties (masseur, exercise therapy doctor, physiotherapist, etc.).

You can get a preliminary consultation with specialists on the condition of the child's feet by filling out the form (for a child under one year old with photos of the feet, over 1 year old with photos of the feet and a video of walking).

Hello dear readers! I recently wrote an article. Today I wanted to consider in detail one of its varieties, valgus deformity of the foot in children. Parents do not always pay enough attention to this disease, but in vain. Flat feet can result in severe pain and curvature of the spine for the child.

Valgus foot - what is it?

Plano-valgus deformity is a defect of the foot, in which its arch decreases, and the axis of the limb acquires an X-shape. At the same time, the toes and heels turn outward, the midfoot falls. The baby's gait becomes clumsy, he quickly gets tired and complains of pain in his legs.

At home, parents, knowing what it is - a valgus foot, can easily check if their crumbs have this defect. To do this, just ask him to stand up straight and tightly squeeze his knees. In this position, the distance between the inner edges of the ankles should be more than 5 cm.

If you look at the child’s legs from the side, then even with the “naked eye” you can see how the foot falls inward, and the legs look like the letter “X”, as in the photo.

Flat feet can be presented in varying degrees depending on the degree of deviation of the arch of the foot:

  • from 10 to 15 degrees - the defect can be easily corrected;
  • from 15 to 20 degrees - it will take effort to correct the deformation;
  • from 20 to 30 degrees - you need a long complex treatment;
  • more than 30 degrees - surgery may be required to correct the defect.

Depending on the causes that gave rise to the disease, flat feet are of two types:

  • congenital (violation of the shape of the bones and their location occurs even during fetal development);
  • acquired (weakness of the muscular and ligamentous apparatus, as well as other factors lead to foot deformity during the period when the baby begins to learn walking).


Up to what age can a hallux valgus be corrected in children?

If the baby is diagnosed with "flat-valgus foot", the situation can be corrected up to 14-15 years. Until that time, the child is registered with an orthopedist and undergoes regular treatment. How to fix, read on. I am sure that everything will work out for you, because if you are reading these lines, then you are on the right track.

Treatment of valgus foot in a child

The course of treatment depends on the age of the baby and the degree that the deformation has reached in its development. If flat feet are congenital, special techniques are used to diagnose it:

  • computer plantography - the doctor examines the parameters of the foot;
  • podometry - a computer study that allows you to determine the nature of the foot and the load on its individual parts.

If a pathology is detected, splints and splints are used for treatment, which allow fixing the limbs.

Trays

In older children, the therapeutic course involves a number of procedures. Great importance attached to foot baths. The water temperature for the procedure is about 40 degrees. Add sea salt to the water and keep the legs in the bath for half an hour.

To enhance the effect, you can put a massage mat in a container of water and ask the baby to walk on it. The procedure strengthens the muscles and at the same time does not create additional stress on the legs.

Do not ignore this seemingly unnecessary procedure, the effect is worth it.


Massage

Massage is another method that relieves muscle tension, making muscles and ligaments stronger and more elastic. It improves blood circulation and normalizes the development of limbs. To get rid of a flat-valgus foot, you need to massage your back, then move to the lower back and buttocks, then along the legs to the feet (at the end of the article there will be a detailed video about massage techniques and gymnastics):

  • First, perform stroking movements along the back towards the neck. Then bend your fingers and rub your back, moving one hand up and the other down. We complete the procedure with rubbing movements.
  • Massage the lumbar region from the spine.
  • On the gluteal region, stroke with the back of your fingers or pat.
  • Massage the legs from the thigh to the dimples under the knees, then knead the entire back of the leg.
  • In the lower leg area, focus on relaxing movements: rubbing and shaking.
  • With foot massage Special attention remove the notch between the heel and toes by rubbing and stroking.

Physiotherapy

Along with massage and baths, other physiotherapy procedures are also used:

  • ozocerite baths or;
  • wax wrap;
  • electrophoresis;
  • swimming;
  • acupuncture;
  • electrical stimulation;
  • walk on pebbles, sand, barefoot, on a rug;
  • magnetic therapy.


Exercises

At home, if it is not possible to visit a specialist, you can do the exercises yourself:

  • Turn your feet inward with the soles.
  • Bend the back of your foot.
  • Bend the sole.
  • Bend your toes.
  • Grab small toys, pencils, pens with the sole (masseurs even advise you to draw with a pencil in your foot).
  • Rotate your feet.

If you have the opportunity to attend classes at a medical center and see how flat feet are treated with exercise therapy, this is a big plus, since you can perform these exercises at home without outside help.

And here is the long-awaited video about massage and simple exercises:

Special footwear

An obligatory element of treatment is special shoes, called "orthopedic". Its main difference from ordinary shoes is that on the inside of the foot there is an elevation on the insole that supports the arch of the foot and the correct position.


The heel is maximally fixed, the foot is fixed. It is best to order shoes individually for your child. But if this is not possible, purchase standard orthopedic products or insoles that can be placed in ordinary shoes.

Surgery

In severe cases, surgical treatment is used to eliminate the deformity. There are several types of surgery, but the essence of them is that the ligaments are either cut or attached to the bone in order to minimize its mobility.

Surgery for children is rarely used: in most cases, a good result can be achieved using preventive methods.

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See you soon, dear readers!

Valgus foot placement is an actual problem in pediatric orthopedics. This is a deformity of the foot, prone to increase and can cause a number of diseases of the musculoskeletal system. Correction of the installation of the foot at an early age allows you to achieve a 100% result, avoid surgical intervention and possible disability after growing up.

Valgus deformity of the foot is a curvature of the axis of the foot, resulting in displacement of the knee joints to the medial line, adduction of the feet with pronation and inward collapse. The patient's heels turn outward, and when the legs are brought together, the ankle joint forms an X-shape.

When there is a decrease in the height of the arches of the foot, a plano-valgus deformity of the foot is diagnosed.

At the same time, the distribution of loads on other structures of the musculoskeletal system, which are not physically ready for this, changes. Pathology, which began with a minor defect, can give rise to chronic diseases: arthritis, arthrosis, bursitis, scoliosis.

If left untreated, the deformity of the foot develops progressively and gradually goes through 3 stages, which are referred to as "severity".

Degrees of valgus deformity of the feet in a child

  • I degree.

Arch height 15 mm, heel angle 15°, forefoot abduction 10°, hindfoot up to 10°. This degree is easily corrected by physical therapy, massage.

  • II degree.

Arch height up to 10 mm, heel tilt up to 10°, forefoot abduction up to 15°. A long-term complex of conservative measures is required.

  • III degree.

Arch height up to 5 mm, heel tilt up to 5°, forefoot and hindfoot abduction over 20°. Pathology is difficult to treat, in most cases surgical intervention is necessary.

There is a physiological norm for valgus feet. This is a divergence of the inner edges of the ankles for a distance of up to 5 cm when bringing the knees together. In these cases, the installation of the feet returns to normal by 5-6 years without treatment.

Causes of pathology

Valgus deformity can be congenital or acquired. The congenital form of the pathology is formed due to violations of the shapes and locations of the bones of the foot during the laying and development of the fetal musculoskeletal system.

The formation of the acquired form of pathology is due to muscular hypotension, connective tissue dysplasia, underdevelopment or deviations in the development of the tendon-ligamentous apparatus and static-dynamic relationships of the structures of the lower extremities.

  • prematurity of children;
  • intrauterine malnutrition;
  • rickets;
  • perinatal encephalopathy;
  • myodystrophy;
  • polyneuropathy;
  • deforming diseases and injuries of the joints;
  • a significant excess of the age norm of weight.

It is possible to combine pathology with congenital dislocation of the hip, cerebral palsy, poliomyelitis.

A frequent cause of the pathology is the forced presence of children in an upright position (the use of walkers, jumpers). The development of deformity is facilitated by prolonged and frequent infectious diseases at an early age.

Hallux valgus signs

Visual signs of a foot defect in a child can be seen when he begins to walk. When walking, he steps on the inner edge of the foot.

Warning signs are the alignment of the heels and the divergence of the socks during a standing position. If you look at the patient's legs from behind, you can notice the curvature of the ankle joint.

The X-shaped deformity of the ankle joint excludes a straight gait. The patient walks with widely separated feet, steps uncertainly, shuffles. Additional signs:

  • increased fatigue;
  • refusal to walk
  • pain in the foot, knee, spine;
  • swelling of the feet;
  • trampling on the inside of the sole of the shoe.

When these signs appear, you need to contact an orthopedist. Comprehensive treatment of valgus foot placement is important to start at an early age. Until the age of 5-6 years, the joints consist mainly of cartilaginous tissue, which has an elastic structure and is relatively easy to correct.

Hallux valgus treatment complex

The goals of pathology treatment are to restore the optimal shape of the foot, corresponding to age, strengthen the ligaments and muscles, and prevent deformation of other parts of the musculoskeletal system. The effectiveness of therapeutic measures depends on the regular and correct implementation of the recommendations of the orthopedist.

Therapeutic exercise (LFK)

Exercise therapy plays a leading role in the correction of the valgus installation of the foot. Active and regular exercise strengthens muscles, bones and tendons. Gradually, as endurance increases, these structures will be able to support the arch of the foot and the load from the child's body weight.

Walking on the path

The exercise teaches the child to walk correctly, not to scatter the feet around. This contributes to the correct installation of the foot.

For this, a straight pattern of a carpet or a line drawn on the floor is suitable. A prerequisite is that the width of the track should not exceed 15 cm.

Treadmill

Soviet-made roller treadmills are the most efficient. These are structures made of small discs that irritate the nerve receptors of the foot and strengthen the soles of the feet.

Walking on the tree

For this exercise, leaflets or other material are laid out on the floor in the form of a “Christmas tree”, so that the child, stepping on them, brings the toes of the feet inward.

Walking on a triangular board

Exercises strengthen the muscles of the sole, stretch the outer part of the foot and regulate supination. They practice two options for walking on a trihedral board: in a straight line (pose of a tightrope walker) and stepping on two different sides.

Walking on the gym track

The exercise stimulates the activity of the plantar muscles, strengthens the longitudinal arch of the foot.

For this exercise, you will need a rope ladder, which is laid on the floor, and the cross beams are tightly brought together.

Walking on a rough surface

The purpose of this exercise is to stimulate the raising of the arch by stimulating the nerve receptors of the sole. Massage stone paths are used as inventory, which can be purchased in specialized stores.

A rug with a relief surface can be made with your own hands. To do this, large buttons or other atraumatic details are sewn onto a piece of fabric.

Walking the path of sensations

This method of exercise is useful not only for the installation of the foot, but also for the nervous system as a whole. The track of sensations is a combination of soft, hard, embossed, elastic areas. The track must include at least four sections that are different in tactile perception.

Massage balls and balls

A good therapeutic effect is obtained by the regular use of balls and balls of different sizes with soft spikes. At the same time, exercises are performed with the capture and transfer of the foot, kneading in place and rolling under the sole of the medical device.

These are the main devices that should be used in the treatment of hallux valgus. There are other exercises designed for the age of the child and the severity of the deformity of the foot.

Therapeutic massage and exercises

The main role of therapeutic massage is the regulation of muscle tone and stimulation of local blood flow. This is a technique that combines reflex and mechanical effects on the legs, spine and lumbar of the patient. At the same time, simultaneous effects of different forces on the zones of overstretching and tightness are practiced to regulate muscular dystonia.

This is a rather complicated procedure that requires specific knowledge and skills for proper implementation. Therefore, parents of a sick child are advised to contact a children's masseur for the first course of the procedure. A specialist needs to learn the technique of daily massage.

Professional massage should be done 3-4 times a year in courses of 10-12 procedures.

Orthopedic shoes with leather insole

The purpose of wearing orthopedic shoes is to prevent further deformity of the ankle joint.

  • Genuine Leather;
  • hard back for fixing the heel;
  • laces that firmly fix the foot;
  • lining from soft tissue to prevent chafing;
  • low stable heel;
  • leather insole with a low arch support;
  • expanding toe;
  • dense, but not heavy sole.

Despite the general similarity, each person has an individual installation of the foot. Therefore, it is unacceptable to wear orthopedic shoes after other children. This also applies to the selection of everyday shoes.

According to individual indications, the doctor may prescribe the wearing of orthopedic insoles, digital correctors or screeds. Basically, these are individual designs, made to order and changing as the foot grows.

Physiotherapy

Physiotherapy for hallux valgus is considered as an additional method of treatment. The type of procedure and course of treatment is selected by the attending physician.

Main methods:

  • electrophoresis with potassium iodide;
  • magnetotherapy;
  • mud treatment;
  • paraffin therapy;
  • diadynamic therapy.

The procedures are aimed at strengthening the ankle joint, ligamentous apparatus and increasing muscle tone.

Surgery

Indications for surgical treatment are the ineffectiveness of the treatment, high risk deformations of other structures of the musculoskeletal system. The surgical method also treats severe degrees of congenital pathology.

Since structural changes occur as the foot grows, repeated recurrences of the disease are possible. Therefore, in most cases, it is advisable to wait for the end of foot growth. This happens at the age of 14-15.

Main methods:

  • osteotomy;
  • exostectomy;
  • arthrodesis;
  • joint replacement with implants;
  • arthroplasty.

There are about 100 methods of surgical correction of pathology. The choice of a specific treatment strategy depends on the characteristics of the deformity and the age of the patient.

This video contains a set of therapeutic exercises for children with hallux valgus stop.

Prevention

Since the main factors of pathology are known, prevention is carried out by the method of their elimination and prevention. Preventive measures are especially important for premature babies with underdeveloped connective tissue and with a weak immune system.

Basics of prevention:

  • exclusion of load on the legs up to 7-8 months;
  • refusal of forced verticalization (walkers, jumpers);
  • taking vitamins and macronutrients aimed at strengthening the skeletal system;
  • hardening, therapeutic exercises, massage, walking barefoot;
  • healthy nutrition with a full range of nutrients;
  • selection of shoes in accordance with the size of the foot;
  • prevention and rapid treatment of infectious pathologies.

It is important to relieve leg fatigue in a timely manner. To do this, every evening they do a light foot massage and relaxing warm baths with herbs of sage, yarrow or mint.

Differences of pathology with other types of foot deformities

It is useful for parents of newborns to know the differences between the main types of foot deformities that are most common in orthopedic practice.

Varus deformity

With this type of deformity of the limbs, when bringing the legs together, the knees do not touch. A gap is formed between the ankle joints, resembling the shape of the letter "O". Up to 1 year, varus divergence of the limbs is considered the norm; at an older age, correction is required.

Clubfoot

A typical clubfoot is characterized by equinus (displacement of the heel upward, curvature of the foot in the plantar direction), varus (turning the heel inward), adduction (bringing the forefoot), supination (turning the inner edge of the foot upward).

Additional signs of an atypical form of deformity are a transverse fold on the sole, the feet are shorter than the age norm, the bones of the metatarsus are bent plantar.

Parents and children with any foot deformity need to get used to the new lifestyle. This is an introduction to the daily schedule of therapeutic exercises, other procedures recommended by the orthopedist. At first, this may seem complicated and take a significant amount of time. In addition, not all children are happy with innovations.

You can arouse the interest of the child by organizing healing procedures in a playful way and explaining their significance in an accessible way. A play corner equipped with bright medical equipment, cheerful background music, and the interest of the parents themselves in a kind of “game” can help with this.

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