Today, orthopedic surgeons routinely diagnose flat-club feet in children.This deformation involves sinking of the inside of the foot.That is, the straight axis from the calf to the foot is curved.Visually, you can also see that the height of the outer arch of the foot is reduced.The longitudinal arch in the foot disappears.A characteristic feature of flatfoot-valgus deformity in children is the position of the legs in the shape of an "X".This will be clearly visible if the child stands straight.
In rare cases, valgus flat feet may be congenital, but more commonly they are a deformity that occurs in children younger than 3 years of age.This foot position becomes apparent when your baby takes his first steps.At this stage, parents should react and take their child to an orthopedic surgeon.
sheet
There are two forms of flat feet: congenital and acquired.Congenital malformations are diagnosed by doctors as early as the first month of life.The disease occurs during development in the womb.This usually occurs due to a genetic predisposition.
Congenital planar valgus deformities may occur in very severe forms.For example, rocking feet and vertical rams.Babies with Edwards syndrome most commonly develop foot shaking.Vertical talus is a complex foot pathology that requires surgical treatment.The most common is tendon surgery, which involves grafting, lengthening or adjusting the scaphoid.But sometimes this can only be achieved through plaster casting.
With acquired deformities, the structure of the foot changes under the influence of various factors.This is usually due to reasons such as a weak and incomplete tendon-ligament apparatus.
reason
The main cause of valgus flat feet in children is weakness of the tendons and aponeuroses of the feet.And due to the considerable load on the child's musculoskeletal system after one year, the legs begin to bend and the feet sink inward.Therefore, all the arches and arches of the foot are not developed correctly.
Factors that cause valgus flat feet also include:
- Rickets In this disease, bone tissue becomes weak and deformed;
- Muscle paralysis.This may have been after polio;
- With other serious diseases - cerebral palsy (CP), polyneuropathy, muscular dystrophy;
- Infectious or viral chronic diseases that cause circulatory problems;
- Trauma to feet and legs;
- Various dysfunctions of the endocrine system.For example, overweight or underweight, diabetes, etc.
- Lack of nutrition, improper diet, lack of vitamins and minerals in the body.
Doctors point out that bunions can occur due to improper shoe selection for your child.Shoes with flat or soft soles or without hard back and instep support are prohibited.Especially suitable for children under 3-5 years old.
This risk group also includes children who lead a sedentary lifestyle if they do not engage in any physical activity.
Congenital flatfoot is common in premature babies and when the fetus is underweight in the womb.
signs and symptoms
Telltale signs of foot deformity in children are:
- Gait changes.The child walks awkwardly, dragging his feet and having unsteady steps.
- When walking, you mainly step on the inside of your feet.
- Poor posture and hunched back always accompany foot deformities in children.
- The feet are irregularly shaped and compact.In children, the feet appear plump.
- X-shaped legs.
Parents may also notice other symptoms in their children:
- Legs are tired and may feel sore at the end of the day;
- Headache;
- Back pain.
Damage
There are 4 main stages of flatfoot-valgus deformity.The curvature does not exceed 15 in the initial stage0.Many children have this disease, but as long as parents detect the problem in time, it can be corrected easily and quickly.
In the second stage, the curvature of the foot reaches 200.This level of damage requires longer treatment but can produce positive results.
In the third stage, comprehensive treatment of children's flat-club feet is needed before the treatment can be long-term.At this stage, the heel deviation is 300.Stage IV is diagnosed when the curvature exceeds 300.This deformity can only be corrected surgically by a qualified specialist.
diagnosis
The diagnostic process begins with an orthopedic surgeon performing a vision exam on your child.Next, the child is referred for additional studies in order to determine the extent of the deformity of the child's foot.in:
- X-ray – This study helps doctors determine exactly whether a bunion is present and how advanced it is.To do this, the photo needs to be taken with three projections.
- Pedometer is a computerized diagnostic method used when a deformity is suspected and difficult to diagnose visually.That is, the symbol is not expressed.
- Ultrasounds are performed on children to see the condition of their joints and whether there are any other concomitant conditions.
- Computed plantar photography is a study in which the feet are scanned on a specialized platform.Computers are capable of determining various morphological parameters.In this case, the doctor will look at how the load is distributed on the foot.Plantar photography may also be performed with a stress test.
Orthopedic surgeons will refer young patients to neurologists for consultation to accurately determine whether there is a central nervous system disease.Other specialists to consult are surgeons and endocrinologists.
treat
Flat-valgus feet in children require treatment at any stage of the deformity.This depends on the extent of the damage.The main goal of treatment is to restore the normal position of the foot.In the first stage it is enough that the child wears correct orthopedic shoes and engages in physical activity.There are special foot gymnastics that parents can do with their child in a fun way, so that he will want to be treated.Sometimes therapeutic massage sessions are also prescribed at this stage.These treatments help strengthen local muscles and ligaments.
Conservative treatments for other stages of flatfoot in children include paraffin therapy, therapeutic massage, and gymnastics.They also use physical therapy in the form of electrophoresis, magnetic or electrical muscle stimulation.
Paraffin therapy is performed in a children's clinic.Paraffin wraps around the entire foot and extends to the shin, like a tall boot.Once you have completed this step, you are ready to start your massage.This will be very effective as the muscles will soften after paraffin waxing.
If a child has bunions, therapeutic massage can only be performed by a qualified specialist.You can do it at home if the expert allows it and your parents guide you.
surgical treatment
If all conservative treatments are ineffective or the parents seek medical attention early, surgical treatment may be necessary.
Treatment of flat and valgus deformity of the foot can be performed using the Dobbs method.This involves manual correction of the foot and a plaster cast.Approximately 6 surgeries are required, performed one week apart.After each week, the position of the foot during the casting process will change.The cast starts at mid-thigh, with the leg bent at the knee.At the end of treatment for flat-valgus feet, the doctor must fix the talonavicular joint in the correct position.To tighten, the doctor will install a Kirschner wire, which is inserted into the skin.The cast should immobilize the leg for about 2 months.After that, a plaster cast is applied in the form of a boot.Next, braces are recommended, that is, special shoes with the desired shape.Children should wear them regularly and only after a certain period of time during the day and at night while sleeping.
Planar valgus deformity of the foot can also be corrected with minimally invasive surgery.This changes the angle between the bones, which increases the tension on the ligaments.
Arthrodesis is rarely used in children because it can cause severe trauma and postoperative pain when walking.In pediatric bunion surgery, the doctor creates a fixed connection between the talus and calcaneus bones, thereby strengthening the muscles of the inner arch.
as a result of
Prompt diagnosis of bunions is important because 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 development of arthrosis, arthritis, cervical spine disorders and persistent pain in the legs.
prevention
To maintain the effectiveness of the treatment, the child must wear specialized orthopedic shoes.All shoes should reach shin height and have rigid arch support.Be it sandals or boots.
You'll want to buy insoles that fit flat-pronate feet and can be inserted into any shoe.But only if these are high heels.
In addition to daily exercise and an active lifestyle, it is very important for children to do foot gymnastics.It is prescribed by doctors, but the simplest exercises are:
- Use the inside, outside, and heel of your foot when walking;
- Use your foot to step on a rolling pin or other round object;
- Pick up objects with your toes and draw;
- Perform foot rotation.