Today, orthopedists very often diagnose flat feet in children.This deformity includes sinking of the inside of the foot.That is, the straight axis going from the leg to the foot is bent.Visually, you can also see the height of the outer arch of the foot decrease.The inner longitudinal arch of the foot disappears.A characteristic feature of planovalgus foot deformity in children is the position of the foot in an “X” shape.This will be clearly seen if the child stands up straight.
Valgus flat feet in rare cases can be congenital, but more often it is a developmental deformity in children under 3 years of age.This position of the feet becomes noticeable when the baby takes his first steps.At this stage, parents should react and take the child to an orthopedist.
Form
Valgus flat feet can be of two types: congenital and acquired.Birth defects are diagnosed by doctors within the first month of life.This disorder develops during intrauterine development.Quite often this happens due to genetic predisposition.
Congenital plano-valgus deformity can occur in very severe forms.For example, here are the rocker legs and the vertical ram.Rocking feet most often develop in children with Edwards syndrome.Vertical talus is a complex foot injury so treatment requires surgery.Typically, these are tendon surgeries in the form of implants, lengthening or adjusting the scaphoid bone, etc.But sometimes they are only possible by plaster casting.
With acquired deformity, the structure of the foot changes under the influence of many different factors.This often happens due to weak and incomplete ligament-tendon apparatus, etc.
Reason
The main cause of flat feet in children is weakening of the foot muscles.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.Accordingly, all the arches and arches of the foot develop improperly.
Factors that cause 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;
- a chronic disease of an infectious or viral nature that contributes to circulatory problems;
- injuries to the feet and legs;
- Various functional disorders of the endocrine system.For example, being overweight or underweight, diabetes, etc.
- malnutrition, poor diet, lack of vitamins and minerals in the body.
Doctors note that hallux valgus can develop due to the child's incorrect choice of shoes.Wearing shoes with flat, soft soles, without a stiff back and instep support is contraindicated.Especially children under 3-5 years old.
The risk group also includes children who lead a sedentary lifestyle if they do not perform any physical exercise.
Congenital hallux valgus often appears in premature babies and in cases of low birth weight babies in the womb.
Signs and symptoms
Visible signs of this foot deformity in children are:
- Changes in gait.Children walk awkwardly, shuffle their feet, and walk unsteadily.
- When walking, he mainly steps on the inside of his foot.
- Wrong posture and stooping always accompany foot deformities in children.
- The feet are out of shape and compressed.In children, the feet appear plump.
- X-shaped legs.
Parents may also notice other symptoms in their children:
- Legs are tired and may hurt at the end of the day;
- headache;
- back-ache.
Extent of damage
There are four main stages of planovalgus foot deformity.In the early stages, the curvature does not exceed 150.Many children suffer from this disorder but it can be overcome very easily and quickly if parents notice the problem in time.
At the second stage, the curvature of the foot reaches 200.This level of damage requires longer treatment, but it gives positive results.
In the third stage, comprehensive treatment of flat feet in children is required, and the treatment will be long-term.The heel at this stage is deviated 30 degrees0.And the fourth stage is diagnosed in cases where the curvature is greater than 300.This deformity can only be corrected by qualified professionals through surgery.
Diagnose
The diagnostic process begins with a visual examination of the child by an orthopedist.Next, to determine the degree of deformity of the child's foot, the child is transferred to other studies.Among them:
- X-ray – this study helps the doctor accurately determine the presence of hallux valgus and the extent of its development.To do this, the photo is taken in three views.
- Podometry is a computerized diagnostic method used when a deformity is suspected if it is difficult to diagnose visually.That is, the signs are not expressed.
- Ultrasound is performed on children to understand the condition of the joints and whether there are any other diseases present.
- Computational plantar photography is a study in which feet are scanned on a specialized platform.The computer can determine various morphological parameters.In this case, the doctor will understand how the load is distributed on the foot.Planting can also be done with stress tests.
The orthopedist will refer the small patient for consultation with a neurologist to accurately determine whether a disease of the central nervous system is present.Other specialists that should be seen are surgeons and endocrinologists.
Treatment
Treatment of 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.At the first stage, it is enough for the child to wear suitable orthopedic shoes and participate in physical exercises.There are special exercises for the feet that parents can do with their children in a playful way so that the child will want to be treated.Sometimes at this stage, a course of therapeutic massage is also prescribed.Such treatments help strengthen local muscles and ligaments.
Conservative treatment for other stages of flatfoot in children includes 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 children's clinics.Paraffin wrapping is done over the entire foot and extends to the shin, like a high boot.After this procedure, you can begin massage.This will be quite effective because the muscles are softened after applying paraffin.
If your child has hallux valgus, massage therapy should only be performed by a qualified specialist.You can do it at home if allowed by a specialist and guided by your parents.
Surgical treatment
If all conservative treatments do not work or the stage where the parents seek medical attention has progressed, surgical treatment will be applied.
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 over a period of one week.Every week, the position of the foot in the cast will change.The cast starts from the middle of the thigh, with the leg bent at the knee.At the end of this stage of treatment for hallux valgus, the doctor must fix the talonavicular joint in the correct position.And to tighten it, the doctor will insert a Kirschner wire, which is threaded through the skin.The cast will immobilize the leg for about 2 months.Then a layer of plaster is applied in the form of a boot.Next, braces should be applied, that is, special shoes of the desired shape should be worn.Children should wear them constantly and only after a while should they wear them when sleeping during the day and at night.
Plano-valgus foot deformity can also be corrected with minimally invasive surgeries.This changes the angle between the bones and as a result the tension of the ligament increases.
Joint fusion surgeries in children are extremely rarely used, as this leads to high levels of trauma and subsequent pain when walking.During bunion surgery in children, doctors create a permanent connection between the talus and calcaneus bones, thereby strengthening the muscles of the medial arch.
Consequence
It is very important to promptly diagnose hallux valgus, because as the disease progresses, the musculoskeletal system will be increasingly affected.This leads to the appearance of clubfoot, scoliosis and flat feet.This is also the premise that leads to the appearance of joint diseases, arthritis, cervical spine diseases and constant pain in the legs.
prevent
To maintain the therapeutic effect of the therapy, the child must wear specialized orthopedic shoes.All shoes must be mid-shin high and have sturdy arch support.Could be sandals or boots.
You need to buy an insole for plano-valgus feet, which can be put on any type of shoe.But only on the condition that these are high shoes.
It is very important that children, in addition to daily exercise and leading an active lifestyle, also exercise their legs.It is prescribed by doctors, but the simplest exercises are:
- walk on the inside and outside of the foot, on the heel;
- Use a rolling pin or other round object to pump;
- Pick up objects and draw with your toes;
- Do leg swings.