Causes of flat valgus foot in a child. We treat hallux valgus in a child - what is it? Treatment methods for hallux valgus in children's feet

Parents eagerly await their baby's first steps. This joyful event is sometimes overshadowed by the fact that the child begins to walk on tiptoes or has a slight clubfoot. What could be the reason? Most likely it is a case of valgus flatfoot. How to properly treat the disease, we will consider in the article.

What is hallux valgus?

Doctors usually detect hallux valgus deformity in children aged 1.5 to 3 years. The legs are a little clubbed, and the feet resemble the letter X.

Parents themselves can notice the problem if they look closely at how the baby walks.

Child actively rests on the inside of the foot . When walking, he steps unsteadily and gets tired quickly.

Simple test

How to quickly see hallux valgus? Do a simple test:

1. sit the baby down;
2. straighten the child's legs;
3. press your kneecaps;
4. pay attention to the distance at the ankles. Ideally there should not be more than 3 cm, if the distance approaches 4 cm- this is a reason to see a doctor.

Along with hallux valgus, orthopedists make an additional diagnosis – flat feet. In this case, the disease is called planovalgus foot. In this case, the height of the arch of the foot itself will be significantly reduced.

If you place a child’s foot on the sand, you should pay attention to the remaining imprint. The width of the foot in the middle should not be more than 1/3 of the entire width.

It is important! The doctor can easily diagnose a hallux valgus deformity in a 1–3 year old child; it is clearly visible. But flat feet are not detected until 2 years of age. More precisely, children’s feet are physiologically flat.

Causes of hallux valgus

Before treating the disease, you need to find out the cause of hallux valgus.

1. Congenital. Even in the womb, the baby's feet are formed incorrectly. Medicine has not yet figured out the reasons for this. This pathology cannot be seen on ultrasound. Congenital pathologies are usually the most severe. An experienced pediatrician will be able to see the problem literally immediately after the baby is born.
2. Acquired . There are many reasons for this: parents put the baby on his feet early, the baby walks exclusively on a flat floor, incorrectly selected shoe size, and more.

At risk are children who have the following problems:

• muscle atrophy;
• rickets.

Obesity can be a factor in the development of hallux valgus.

Advice! Many parents want their baby to walk faster. Experienced pediatricians say that the ideal time for this is 1-1.3 years. Previously, the bones, muscles, and ligaments of the baby were simply not ready for such loads.

Separately, we need to talk about walkers, which modern mothers love to buy. For a child, this accessory is a real evil.. Frail lower limbs receive a colossal load, plus children often begin to walk on their toes, which eventually becomes a habit.

Degrees of valgus defect

The sooner you see a doctor, the greater the chance of correcting hallux valgus. It all depends on the stage of the disease.

1. First degree . The doctor cannot always clearly confirm the disease; an x-ray is prescribed. Deviation angle is too small. Treatment is fast.
2. Second degree . In this case, it is no longer possible to do without a course of massage, special physiotherapeutic procedures and therapeutic exercises.
3. Third degree . The deflection angle is significant, more than 30–35 degrees. The problem is already visible even to the naked eye. The treatment is long, parents and children need to be patient and follow all the doctor’s recommendations every day. There is a positive prognosis with appropriate treatment.
4. Fourth degree . The deformity is so severe that the child sometimes cannot walk. In most cases, surgery is prescribed.

You cannot delay treatment, otherwise the disease will be very difficult to eliminate.

Diagnostics

How to recognize the disease? If parents notice the slightest changes in the baby’s gait, they need to contact a surgeon.

The specialist will prescribe the following diagnostics:

• visual inspection;
• x-ray of feet;
• computer diagnostics;
• podometry.

Advice! If a child has been diagnosed with hallux valgus and flat feet, It is advisable to undergo an additional examination by a neurologist. Often children with such ailments are diagnosed with problems with the nervous system (developmental delay, autism, hyperactivity and much more).

Treatment methods

Treatment should be comprehensive:

1. Orthopedic shoes . It must be made strictly to order. The shoemaker takes individual measurements from the child, paying attention to his problems. In some places the insole will be raised, as it should be.

   Advice! You can’t wear orthopedic shoes for someone, they won’t do any good.

2. Massage. Must be done by a specialist.

   The child is massaged not only the feet, but also the buttocks, hips, and knee joint. It is necessary to undergo several massage courses, with breaks of a month.

3. Exercise therapy. Specialists work with children in these classes. They perform a number of exercises to strengthen muscles and ligaments.
4. Steam therapy . The child’s feet are dipped into warm wax, thus warming up the muscles, tendons, and joints.
5. Physiotherapy . This can be electropheresis, muscle stimulation with low current frequencies.
6. Baths with medicinal herbs . They relieve fatigue, swelling, and normalize blood circulation.

The child should also study at home. For this, the mother is asked to make special rugs (from chestnuts, acorns, cereals). The child must run on them.

But the baby should also be taken to the sea as often as possible, take off his shoes and be allowed to run barefoot on pebbles, sand and shells.

Such children should be sent to a specialized orthopedic group in kindergarten.

conclusions

Hallux valgus in children is a diagnosis heard by every 5 parents. The problem is quite acute and serious.

If you do not get rid of the disease in childhood, you will have problems with your legs in the future: pain, weakness when walking, fatigue , inability to play sports professionally. It is not without reason that people with such a diagnosis are not accepted into the army or military service.

Plano-valgus foot deformity in children is considered an extremely common type of pathology of the lower extremities. Occurs at an early age. If abnormalities in the development of the legs are detected, a common disease is hallux valgus. The cause of the disease is weakness of the ligamentous apparatus of the foot, and the innervation of the leg muscles is disrupted. If the child’s feet have weakened muscles and ligaments, the disease appears after two months of walking. In rare cases, hallux valgus is congenital. The diagnosis is made in the maternity hospital or after the first month of the baby’s life. In order to detect pathology in a timely manner, an examination by an orthopedist is required in clinics.

With plano-valgus pathology, the inner edge of the feet sag, the toes are retracted outward, and the heel deviates to the outside of the foot. Treatment applied in a timely manner eliminates the risk of complications of the deformity. If there is no treatment, the condition of the lower extremities will worsen, leading to X-shaped deformation of the feet, ankles and knees. If there is a defect, the pelvis will be in an unnatural position, and the posture will be impaired. The child will develop pain and early osteochondrosis.

Causes of hallux valgus deformity:

• Violation of mineral metabolism and bone formation;
• Dropping of the arches of the feet;
• Failure in genetics and endocrine system;
• Osteoporosis;
• Incorrect wearing and selection of shoes.

If carried out on time, it will be possible to completely eliminate the disease. To treat the disease, complex therapy is used, including: massage treatment, special gymnastic exercises, physiotherapy (electrophoresis using calcium), acupuncture, selection of orthopedic shoes, swimming, foot baths and magnetic therapy.

Treatment of damaged feet will take a lot of time. The massage course is 15 days, after which they take a break for two weeks. Wearing special orthopedic shoes will help in the fight against plano-valgus pathology; you will need to order them individually. It is better to perform various gymnastic exercises on special massage mats.

The condition of the child’s feet improves after about six months. If after prolonged treatment a positive result is not noticeable, the orthopedist prescribes the wearing of orthopedic splints and foot-correcting devices. Surgery is reserved as a last resort when other treatment methods do not bring a positive result.

Gymnastics for hallux valgus

Gymnastic exercises for plano-valgus deformity of the foot are performed daily, several exercises repeated 2-3 times. Examples of the exercise:

1. The child walks along an impromptu road or a narrow strip (easy to do yourself, a simple way is to draw). A child is not allowed to step outside the boundaries of the path.
2. Walking on the outside of your feet.
3. It is useful to use your toes to scrunch the fabric.
4. Various objects are grasped with the toes. The action increases the functionality of the fingers. The exercises are performed sitting or standing, whichever is more comfortable for the child. It is acceptable to hold the item for a short time.
5. Squats. This must be done so that the foot does not leave the floor. You can hold the baby.
6. Starting position: sitting cross-legged. You need to get up from the accepted position. It is allowed to help by holding the child's hands. When standing up, make sure that your feet are crosswise.
7. Invite your child to stand on his toes, stretching his arms up. Then the child sits back down on his full foot.

Exercise helps cure pathology. Start doing the complex on time, preventing the disease from worsening.

Massage during treatment

At the initial stage of the disease, it is permissible to treat flat-valgus foot in children with the help of massaging. Massage is done in the following ways: shaking, kneading, rubbing, stroking and others. Before carrying out, you will need to prepare properly. The procedure is carried out by a special doctor - a chiropractor (especially important for children under two years of age).

It is required that the treatment method be comfortable for children. To prepare your child for a massage, you can use the following tips:

• You should not massage when your baby is tired, cranky, or wants to sleep. It is better to set the time when the baby is most active. The best time for a massage is after sleep;
• Before performing a massage, you need to prepare the room: in winter it is recommended to ventilate it, providing fresh air; In summer, windows are allowed to be opened;
• In order not to irritate the baby’s skin and improve the massage procedure, it is advisable for parents to apply baby cream and oil to the skin of the child’s feet;
• Parents will have to mentally get used to the fact that the child will cry at first. Children are not used to it and may not like it when their body is kneaded and massaged. It is better if the father stays with the child during manipulations; men, in most cases, have a stronger nervous system. In any case, a parent must be with the child during the massage.

With flat valgus feet, much attention is paid to lumbar massage. There are nerve endings that send impulses to the muscles of the lower extremities.

Manipulations performed by a chiropractor for plano-valgus pathology:

The duration of the massage is at least 12 sessions (for mild illness) or 20 sessions (for severe illness). Massage for hallux valgus lasts 10–20 minutes. The minimum number of courses per year is 3-4.

If the diagnosis is congenital, massage treatment begins at 1.5-2 months. Manipulations are carried out 45 minutes after the child has eaten (avoiding inducing vomiting with manipulations; immediately after eating, the massage will be more difficult for the child). The course is carried out at a time prescribed by the orthopedist. If parents do not know how to do massage, there is no special education or skills, it is better to entrust the child’s health to a doctor.

Choosing shoes for foot deformities

If a child has been diagnosed with flat-valgus feet, parents need to think about the choice of shoes that the child wears. Make sure that children have support on their feet from below and from the sides. You need shoes with a hard back and sides; choose a high and dense instep support. In order not to have to worry about choosing shoes, it is permissible to purchase special orthopedic shoes. There are two varieties: to treat the disease and for prevention.

If the disease has already been diagnosed in children, you will need to choose therapeutic orthopedic shoes. In order for it to better suit the child, and to provide maximum assistance, you need to submit an order to install shoes according to your own parameters (where every nuance of a particular child’s hallux valgus will be taken into account). Wearing orthopedic shoes during illness ensures normal functionality of the muscles (at rest), the load on the foot muscles during movement is distributed evenly.

Benefits of wearing orthopedic shoes:

• The load on the musculoskeletal system is reduced;
• Eliminates further damage to the feet;
• Development of normal posture and gait in the child;
• The development of muscles and ligaments is proceeding correctly.

Surgical intervention

Over time, the treatment of plano-valgus foot becomes more difficult. The older the children are, the worse the disease can be treated with massage or gymnastic exercises. If the chosen methods do not bring results, parents are offered a surgical method of intervention.

Modern operations are less traumatic than before. They do without metal inserts or manipulations to install plaster. During the intervention, the surgeon normalizes the angle in the bones and makes the correct distribution to the ligaments. After such an intervention, children are able to move independently within a day.

Prevention of pathology

Prevention of hallux valgus in children begins before birth. Proper management of pregnancy helps protect future children from congenital and acquired diseases after birth. A pregnant woman should eat properly and follow the doctor's instructions. After the birth of a child, you need to minimize the load on your legs until 7-8 months, so that there is no heavy load on the weak muscles and ligaments of the legs. To correctly assess the health status of children, you need to visit a pediatrician and orthopedist in a timely manner.

Prevention rules for hallux valgus:

1. The load on the legs should be as strong as possible. When the muscles become stronger, the child will begin to learn to stand up and walk. There is no need to overload the unformed ligamentous apparatus. The installation of moderate loads begins when the child is 8 months old.
2. Taking vitamins and proper nutrition will prevent the development of diseases of the musculoskeletal system.
3. Children choose their shoes carefully. Incorrectly chosen shoes will lead to hallux valgus.
4. Physical exercise is good at reducing the risk of lower extremity diseases.

Such simple actions will help in the future to avoid the appearance and development of plano-valgus deformity of the feet.

If hallux valgus deformity occurs in children, treatment should be carried out long and patiently, always under the supervision of specialists - orthopedists.

Signs of hallux valgus

Valgus foot placement in children is one of the most common forms of transformation of the legs in the foot area. This change differs from the normal stance by the extremely low arch and characteristic curvature of the foot.

This disorder causes the longitudinal arches of the feet to flatten and the inner edges to sag.

Photo. Valgus position of the foot in children

Visually, from the top angle, the valgus foot in children looks like the letter “X” (see photo). In this case, in the position of compressed knees, the gap between the inner sides of the ankles is about 5 cm.

What are these - the individual characteristics of a child’s feet, a congenital or acquired pathology, the consequences of a disease or an unhealthy lifestyle?

Doctors classify valgus flatfoot in children as a congenital and acquired pathology. This pathology is diagnosed early - sometimes even in the maternity hospital. However, most often it becomes noticeable around the second year of life, when the baby begins to walk.

Until the age of 5-6 years, this situation can still be corrected, since the legs (like the child’s entire body) are rapidly developing. If at this age the baby’s foot has not straightened, a new and already well-known diagnosis is made - flat feet.

Problems and consequences of hallux valgus

Children's flatvalgus foot deformity is not only an aesthetic defect. This is a pathology of the condition of the lower extremities, which will subsequently certainly affect the further development of the entire musculoskeletal system and lower extremities.

At an early stage of the development of the disease, the child, as a rule, does not experience much discomfort, at least until he begins to walk. However, an experienced specialist, even in the first months of development, is able to distinguish a flat valgus foot in a child from hereditary structural features of the lower extremities.

When the baby begins to walk, the pathological defect becomes noticeable even to the most inexperienced parents. The child has difficulty moving. He is not as mobile as his peers because it hurts him to move around. He complains of pain in his legs, and parents need to take these complaints seriously.

The deformation of the foot becomes especially noticeable due to the change in the shape of the shoe. The child wears down the shoe very quickly where the heel falls inward. In the very first month, shoes become bent to such an extent that they cannot be worn, as the harm to the child’s foot increases.

If this transformation of the child’s legs is not treated, then there is a possibility of developing such disorders as:

• constant pain in the lower extremities;
• pathological circulatory processes;
• curvature in the spine;
• development of arthrosis and osteochondrosis.

It is clear that, after all, a person with such a transformation actually cannot fully move.

A seemingly small transformation in the foot, however, affects the condition of the entire body. An adult experiences constant pain in the legs due to uneven load on the feet, which causes the following consequences:

• the gait changes as the patient tries to walk in such a way as to reduce the pain effect;
• the load on the spine increases, which leads to the development of osteochondrosis;
• scoliosis may develop;
• with a strong transformation of the foot, displacements in the hip and knee joints are possible;
• possible shortening of one of the limbs;
• there is a possibility of developing clubfoot.

Reasons for the development of deformity

The main cause of this disease is weakness of the muscles and ligaments of the foot apparatus. Sometimes such deformation is provoked by the baby walking too early on his own. Parents are always happy when their child is ahead of his peers in development. Sometimes they artificially stimulate their baby to get up on his feet and walk. This should not be done under any circumstances. Each child has his own developmental characteristics. You need to start worrying only when the lag becomes serious. Even in this case, any measures should be taken only after a visit to a therapist, or better yet, to a pediatric orthopedist.

If a child stands on his feet by nine months, then this is not a reason for delight, it is a reason for concern and constant observation. The problem is that the deformity may manifest itself in the first year of walking independently, or may only become apparent several years after the first step. This scatter is due to various reasons for the formation of disorders in the position of the foot.

The causes of deformation may include:

• in the form of consequences of rickets, diabetes mellitus, thyroid pathologies;
• in birth trauma of the lower extremities, especially with displacement of the hip joint;
• in hereditary predisposition;
• too much body weight, putting increased stress on the feet;
• in post-traumatic changes in the foot, knee, hip joints and spine.

Children's shoes are of great importance; if chosen incorrectly, they can become a factor that increases predisposition or already developing deformity. Shoes for children should be comfortable, soft, but with a sole that holds the shape of the foot well.

This requirement especially applies to girls, whose mothers tend to dress them in dress shoes too early.

Do not wear boots, sandals or flat-soled slippers. It must be rigid and rise in the heel area to a height of 1-1.5 cm.

Degrees of the disease and their symptoms

Any disease develops by changing the body. With hallux valgus, these changes are visible to the naked eye. The division into degrees occurs according to the following criteria.

The degree of hallux valgus depends on the angle of deviation of the foot from the norm

1. Foot deflection ranges from 10° to 15°. This is the very beginning of the development of the disease. In this case, with some effort, you can quickly return the normal position of the feet.
2. Deviations from the normal position of the feet by 15 - 20°. This degree is already noticeable even to a non-specialist. The child begins to experience certain difficulties in moving. However, treatment of the disease, although difficult, is quite promising.
3. The deviation from the norm reaches a range of 20 - 30°. This situation is serious, but not hopeless: cure is possible, although it involves great difficulty.
4. When the deviation angle reaches more than 30°, this is considered the greatest degree of development of hallux valgus. In this case, treatment is possible, but extremely difficult.

It is possible that therapeutic treatment is ineffective. In this case, they resort to surgical elimination of the defect.

How is this disease treated?

The treatment course is prescribed only after the orthopedist has made a diagnosis and determined the extent of the disease. Minor deviations in the shape of the foot are not a reason for urgent treatment. The child is changing, and perhaps the leg will change too. Moreover, the foot is finally formed by the age of eleven. However, you need to constantly monitor the situation.

Targeted treatment should begin from the second stage of the disease.

If hallux valgus has developed in children, Komarovsky recommends the following cycle of treatment measures.

1. You must wear orthopedic shoes. If this is not done, then all other treatment methods will be ineffective. The fact is that the leg needs to be constantly installed in the correct position. Treatment is a one-time, although perhaps regular, action, and shoes are a way of constantly influencing the foot.

The doctor decides what kind of shoes you need to wear. In case of severe transformation of the foot, shoes are usually made to order. If the deformation is mild, you can get by with orthopedic insoles, which are purchased in special stores.

1. Therapeutic gymnastics is a mandatory element of the entire course. It is she who puts the child’s leg in the right position, without bringing the development of the disease to an extreme degree when surgical intervention is necessary. Gymnastics is called therapeutic because it is prescribed by a doctor specializing in this method of treatment.

The main focus of such exercises is to strengthen the ligaments, since they are the ones that must hold the foot in the correct position. You need to develop your leg comprehensively. In addition to ligaments, it is necessary to stimulate the development of muscles, which will also affect the formation of bones in the right direction. For this reason, sets of exercises often include gripping various objects with the toes, walking on surfaces with various imitations of roughness, and walking on different parts of the foot.

1. Physiotherapeutic procedures are often prescribed. They do not have a direct effect on the shape and condition of the foot, but help relieve tension and reduce pain. If such procedures do not relieve pain, then painkillers may be prescribed.
2. Changing the foot using surgical correction for valgus transformations of the foot in children is not often used. This is usually considered as a last resort if, for example, therapy has not given any positive effect, or the child has suffered a serious injury requiring radical intervention.

The phrase “surgery” sounds scary, especially for parents. Modern methods of carrying out such events make it possible to do without plaster and complex metal structures. The surgeon changes the angle between the bones by changing the position of the ligaments. This operation does not require large incisions or opening of cavities. As a result, the child can move independently the very next day after the operation - with caution, but without any special supports.

Surgical interventions are allowed as a last resort only for middle-aged and older children. Foot deformities in young children can only be treated with the help of therapy, massage and physical education.

1. Foot massage. This procedure is prescribed for any degree of development of the disease. It is aimed at strengthening muscles, stimulating the development of nerve conduction, improving blood supply to the legs, and raising the overall tone of the body.

The massage should cover the lumbar region, since this is where the innervation of the entire lower body passes. Then the massage therapist works first on the thighs and lower legs, gradually moving to the feet. The intensity and strength of massage movements depend on the degree of deformation of the feet.

The duration of the massage course usually lasts 10 days. However, it must be repeated every 2-3 weeks for 6 months. More precisely, the course and features of the massage are determined by an orthopedist.

A healthy lifestyle and especially nutrition are of great importance in the rehabilitation of a child suffering from foot deformity. The child should receive vitamins and minerals in accordance with the standards existing for this age. Particular importance is attached to the body's supply of calcium and B vitamins. Vitamin D is extremely important for such a child. This entire group of substances strengthens bones and ligaments, preventing them from deviating from normal development.

The general strengthening of the baby’s body is of great importance, since a healthy child moves a lot, developing the muscles and ligaments of the legs.

The most important thing for any disease is prevention. Many diseases can be prevented or detected early. This is especially true for acquired flat-valgus feet in children. Prevention includes the following rules:

• do not force the baby to stand on his feet before 8 months;
• strengthen the baby’s body through outdoor activities;
• do gymnastics every day to strengthen the muscles and ligaments in the feet;
• periodically carry out preventive massage of the entire lower body.

Remember that a healthy child is not only about good heredity, but also about proper development with a healthy lifestyle.

Hallux valgus in children is a very common problem in pediatric orthopedics. Pathology occurs in 80% of cases of ontogenesis of the lower extremities. A significant proportion of abnormal foot development is recorded in children of different ages: from one year to school age.

What is hallux valgus?

This kind of foot deformity is a type of flatfoot, in which the line of the legs shifts inward. In other words, the foot, when walking, under the pressure of the weight, falls inward relative to the position of the axis. However, it does not touch the outside, that is, the lower limbs do not completely contact the surface while walking.

This is how the X-shaped position of the feet is formed (if the anomaly is observed on both legs), which over time is reflected in the lower extremities; they also take on an X-shape. From the outside it looks like this: the legs are connected at the knees, which in everyday life I call “kissing knees.”

This anomaly has two forms of manifestation:

• anatomical (true);
• functional (acquired).

Anatomical deformity is a congenital pathology that can only be corrected surgically, but this is not always done. It occurs as a result of changes in the relative position of the leg bones during intrauterine development. The defect is caused by a severe pathological pregnancy and a genetic factor. The defect is detected immediately in the first months after the birth of the baby.

The functional form is temporary and disappears either on its own or as a result of timely treatment. It occurs due to underdevelopment of the bone elements of the foot, tendons and ligaments, as a result of muscle hypotonia. The reasons that lead to pathology of the lower extremities are often joint diseases and wearing uncomfortable shoes that do not sufficiently fix the foot in the physiologically correct position.

This defect of the musculoskeletal system is typical for weakened children, often premature (hypotrophic), which is caused by a deficiency of nutrients during the period of intrauterine development (embryogenesis). Also one of the reasons for the development of the anomaly is connective tissue dysplasia. The reasons for the development of intrauterine growth anomalies are the consumption of low-quality food and poor ecology. Often this problem is accompanied by congenital dislocation of the hip, hip dysplasia and rachitic bone damage, which also affects the condition of bone elements, ligaments and tendons. Among the factors that can provoke the disease are: child obesity, hereditary predisposition, endocrine diseases. But against the background of obesity and muscle hypotonia, the arch of the foot flattens under the baby’s own weight, and the weakening of the ligamentous and muscular apparatus prevents the foot from being held in a normal, physiologically correct position.

In children of primary school age, hallux valgus can develop after injuries resulting from wearing a plaster cast.

Reasons for the development of the anomaly

The main reason for the formation of pathology is the lack of appropriate healthy loads on the foot, as a result of which the muscles weaken and are not able to function normally, that is, they do not perform the actions that are assigned to them. When the foot muscles experience adequate load (when walking on uneven surfaces), they are toned and effectively redistribute the load across the entire plane of the foot, keeping the body in balance. With hallux valgus, the foot cannot cope with loads, since nowadays a person constantly moves on smooth asphalt and the floor, which relaxes the feet and they lose tone. In addition, wearing the wrong shoes with high heels and platforms prevents the anatomically correct position of the foot when trying to lean on it.

In addition to the congenital nature of the pathology, there are a number of factors that can trigger the development of the defect:

• hereditary weakness of the ligamentous apparatus;
• disorders in the development of the musculoskeletal system;
• early attempt to put the child on his feet (up to 5 months);
• D-hypovitaminosis (due to metabolic disorders);
• phosphorus and calcium deficiency (insufficient dietary intake);
• hip dysplasia;
• obesity in a child;
• injuries of the musculoskeletal system;
• wearing high-heeled shoes in childhood;
• genetic predisposition to flat feet;
• neurological diseases (polyneuropathy).

Curvature of the lower extremities is not the worst complication of a valgus defect. Much more dangerous are the excessive loads experienced by the hip, lumbar, sacral and knee joints as a result of valgus deformity. Because constant stress on these joints will cause displacement of the joints and chronic pain in them. In addition to flat feet, scoliosis, osteochondrosis, joint deformities, arthritis, and asymmetry of the limbs may occur. Therefore, an important task is timely detection of the defect, first of all by parents, and then by a pediatric orthopedist.

Symptoms of pathology

A baby under one year old is not able to talk about his feelings, so the disease is first discovered by the attending pediatrician, who examines the child monthly. But even an attentive parent is able to understand that something is wrong with the child’s legs. If you place a baby under one year old on a flat surface barefoot, then looking at his legs from the back, you can see how the baby falls onto the inside of the foot.

In other words, the baby rests his feet on the inner side of the leg, but almost does not step on the outer part, while the legs remain as if raised. A baby with such a leg defect begins to move funny, which makes some parents touching. You can also check for deformities in your baby by making a wet print of his feet. To do this, wet the baby's feet and make him walk on clean sheets of paper. Footprints will show which part of the foot bears the most stress. With hallux valgus, the imprint will be more pronounced on the inside of the foot.

An adult child may complain of discomfort and pain in the legs while walking, and the pain will bother him not only in the feet, but also in the ankle and even higher: in the knees, hip area and back. The pain can intensify after intense exercise and long walks. The baby may be capricious and complain that it is uncomfortable for him to walk in shoes. And even if he tries to change his shoes, he will still be uncomfortable. It is difficult for such children to choose shoes, since they wear down more on the inner edge. They need special orthopedic shoes or insoles. As a rule, deviations in the development of the musculoskeletal system become noticeable by 10 months, when the child tries to stand on his own feet.

Diagnostics

The defect can be detected during a routine examination by a pediatric orthopedist. An experienced doctor can diagnose the curvature of the foot and the degree of its deformity only by looking at how the child stands. However, in some complex cases, special instrumental diagnostics are performed for accuracy.

Most often this is:

• X-ray examination;
• computer podometry;
• computer plantography;

If parents independently discover a foot defect, then it is necessary to consult a doctor as soon as possible. Firstly, there are cases where treatment is urgently needed, in other cases no treatment is required, and thirdly, individual treatment is required in each specific case. Consultation with a competent specialist is very important, because only he can choose individual tactics for further action.

Treatment

It is possible to correct a foot defect only up to a certain age (10 - 12 years), since it is up to this age that a child’s foot is still developing. However, some experts believe that if no treatment was provided before the age of 8, then the defect (more or less pronounced) will remain with the child forever.

Of course, treatment should be started as early as possible, but not too early. So for the tribe? Almost all children are born with flat feet, because they have not yet had physical stress on their feet. The formation of the foot and its arch will depend on the weight of the baby and only as he stands on his feet. This process begins around the age of three, but quite often the pathology is diagnosed when the baby takes his first steps (about a year). But if you follow medical statistics, then for the first time hallux valgus deformity is detected by 1.5 - 3 years. But in this case, it is too early to talk about the presence of pathology, since such a baby has a fatty layer on the foot, which acts as a shock absorber (due to temporary anatomical flat feet). This situation lasts until the necessary arch of the foot is formed.

Thus, it seems quite natural that when children begin to walk, they place their feet incorrectly, that is, valgus deformity in children under three years of age is a normal physiological stage of development of the arch of the foot. During this period, preventive measures are very effective, which will help shape the arch of the foot and avoid the transformation of a temporary anomaly into a serious orthopedic pathology.

So, foot deformation occurs due to lack of adequate load and muscle training. It follows from this that as soon as the child begins to walk, conditions should be created for him to train the musculoskeletal system. The most effective and simplest way is to walk barefoot. The child should be allowed to walk barefoot not only around the apartment, but also on the ground, grass, sand, and pebbles. You can purchase a variety of massagers in the form of mats and paths that will create various obstacles for your baby’s feet. You can put pebbles in the bathtub and let them walk on it.

However, what if time is lost and the child has already developed a valgus defect? In this case, there is no way to do without treatment. It will be long and painstaking, and also include a whole range of different procedures.

The main treatment for pathology is therapeutic exercises, massage, foot baths, physiotherapeutic procedures (electrophoresis, ozokerite, paraffin therapy, acupuncture, electrical stimulation). Calcium and phosphorus supplements, as well as vitamin D, are prescribed.

Orthopedic products

Orthopedic products are included in the complex treatment of foot defects. Special orthopedic insoles can lift the tilted part of the foot outward to straighten and fix it in the correct physiological position. Therefore, such products are indispensable for diseases of the musculoskeletal system. Insoles, like other orthopedic products, are selected individually, taking into account the size, shape, degree of deformation and anatomical structure of the foot.

However, wearing insoles does not always provide the desired option. In addition to them, the baby will have to wear special orthopedic shoes. Moreover, you will have to wear it all the time, at home in a preschool, school, or on the street. If flat feet are persistently formed, walking barefoot is prohibited, as this will only aggravate the problem. The feet must be fixed in the physiologically correct position so that they get used to it. Therefore, small children are put on orthopedic orthoses and braces to align the correct arch of the foot. Wearing orthopedic orthoses and braces can be very uncomfortable, but this is a necessary measure to avoid surgical intervention.

Surgical correction

Unfortunately, lost time cannot be returned, and if a deformation of the foot has occurred, not many people undertake to correct it surgically at a later age. However, those who still decide will benefit from the operation, the rest will have to come to terms, wear orthopedic shoes and try in every possible way to eliminate the consequences of the deformities.

Valgus curvature of the legs in a child is a fairly common phenomenon. However, not every curvature in children should be considered a pathology. In most cases, the defect corrects itself with age, but the process must be kept under control. If the deformity is a pathological deviation from the norm, then it is necessary to carry out special treatment and even surgical intervention if absolutely necessary. An advanced form of the disease can bring a lot of problems and complications over the years.

The essence of the phenomenon

In general, valgus is an abnormal development of the limb as a result of deformation of the joints in an inward direction. Valgus deformity of the lower extremities can be congenital or acquired:

1. The first type is caused by abnormal development of the fetus in the mother’s womb and is detected in the initial stage (2–3 months of the child’s life) during an external examination.
2. Acquired hallux valgus in children is associated with abnormal development of joints, ligaments and muscles of the limbs or the entire musculoskeletal system. This pathology is detected around 2–2.5 years, when the child begins to move and stand up independently.

The mechanism for the formation of curvature of the limbs in children is based on a certain abnormal process. In any joint of the leg, the internal condyles of the articulated bones develop faster than their external elements, which causes an increase in the joint space in the internal zone with a simultaneous decrease in its size in the external direction. As a result of the formation of such a defect, the ligaments that fix the joint on the inside are stretched.

The feet and fingers are most often affected by hallux valgus. Disturbances of the femur and tibia are somewhat less common. Ultimately, the child’s leg becomes bent, which becomes visually noticeable.

It should be noted that most infant defects of the lower extremities are not pathological. They lead to minor curvatures, and most importantly, they do not progress and disappear spontaneously with age. Special treatment in such circumstances is not required, but monitoring of the process by a pediatric orthopedist is necessary.

Pathological deviations are identified by significant deformation, which gradually increases. They cause improper redistribution of loads when walking, and ultimately can lead to serious joint disorders, including limited mobility. They need to be treated at the earliest stages.

Knee deformity

Valgus deformity of the knee joints in children is considered the most common pathology. It causes an X-curvature of the legs. It is clearly visible when you bring your knees together in a standing position. If there is deformation between the feet, a gap is formed, the size of which indicates the degree of curvature. A non-dangerous deformity is caused by the lateroposition of the quadriceps muscle and is characterized by a deviation from the norm of no more than 5º with a gradual increase to 6–7º (no more). A clinical indicator of pathological deformation is the presence of a gap of more than 5–5.5 cm between the inner sides of the feet.

The congenital nature of deformities of the knee joints is recorded quite rarely and is associated with abnormal development of the femoral neck, foot and lower leg. These pathologies can be unilateral or bilateral. For children, the acquired form of the disease is more typical, most often arising during the initial attempts to stand up and walk independently. Such actions cause significant stress on the knee joint, and the full formation of the child’s muscles and ligaments has not yet been completed.

The most common cause of the defect is an instinct that forces you to spread your legs wide in an attempt to maintain balance. Non-pathological changes should resolve on their own by the age of 8–10 years, and when the deformity does not decrease by this age, therapeutic measures must be taken.

Valgus deformity of the knee in children can be provoked by the following factors:

• a number of diseases (rickets, Erlacher-Blount disease, endocrine and cardiovascular disorders, joint pathologies);
• deterioration of the epiphyseal bone growth regime;
• the occurrence of adduction contracture in the hip joint;
• incorrect choice of shoes (tight, hard shoes);
• overweight;
• knee injuries;
• physical overload.

The main symptom of valgus deformity of the knee joint is severe, which leads to rapid fatigue when walking and pain. The progression of the pathology is directed towards eversion of the limb at the knee joint and ankle, which can cause flat feet, changes in gait, and the development of scoliosis.

Foot deformity

Valgus deformity of the foot in children is expressed in a violation of the position of the foot, namely in the deviation of its sole inward. As is known, normally the angle at which the foot is located relative to the lower leg is 90º, but in pathology it differs from a right angle. As a result of deformation, the arch of the foot decreases and its axis shifts. When looking at the feet from above, an X-curvature is visible. Another common option is flatfoot deformity or flatfoot.

The following main causes of hallux valgus in children can be identified:

• undeveloped foot ligaments;
• endocrine diseases;
• congenital flat feet;
• osteoporosis, i.e. bone fragility;
• overweight child;
• injuries in the ankle and foot area;
• genetic predisposition.

Quite often, children have hallux valgus, with the big toe suffering the most. This defect is caused by pathological changes in the metatarsophalangeal joint, causing the big toe to bend inward. Naturally, the direction of the other toes is gradually disrupted. A characteristic manifestation of the disease is the formation of a “bone” in the joint, which causes pain, swelling, and fatigue when walking.

In advanced stages, the following complications are possible:

• hammertoe curvature;
• formation of calluses and corns with pain and a tendency to an inflammatory reaction;
• severe pain when moving;
• ingrown nail.

Uncontrolled progression of pathology can also cause Deichlander's disease.

Deformation of other joints

Curvature of the legs in a child can cause deformation of the hip joints. The hip most often suffers due to congenital pathologies. One of the common causes is hip dysplasia of varying degrees. The problem is that in infants this type of deformity is difficult to detect visually; only after 6 months is it diagnosed by ultrasound or x-ray. Valgus deformity of the femoral neck causes an increase in the neck-shaft angle. Usually this disease, hallux valgus and flat feet occur together.

Damage to the ankle joint is manifested by a clear displacement of the heel outward and a shift of the foot itself inward, which often provokes plano-valgus flatfoot. This hallux valgus deformity in a child causes intense pain when moving the lower leg and foot. At the initial stage, the pain quickly subsides, but as the disease progresses it becomes more frequent and intensifies. The child develops stiffness in the lower leg, which makes normal movements difficult.

Principles of pathology treatment

If treatment of hallux valgus is started in a timely manner, then the defect can be eliminated using a conservative method. In advanced forms, surgical treatment is used as a necessary measure. Conservative effects are ensured by the following methods:

1. Orthopedic measures. Depending on the affected joint, various orthopedic devices are used. Corrective placement and special fixing splints are used for the knee, ankle or hip joints. If the foot and fingers are affected, orthopedic shoes, insoles and various fixing elements are used.
2. Physiotherapeutic effects. Experts consider muscle electrical stimulation to be the most effective method by delivering weak electrical impulses with adjustable duration.
3. Massotherapy. A full range of procedures, such as stroking, rubbing and kneading the lumbar area; massage of the buttocks and sacral area; active impact on the posterior femoral area; kneading, stretching and vibration of the lower leg muscles; corrective knee massage; stroking and rubbing the Achilles tendon; foot treatment.
4. Exercise therapy for hallux valgus is developed by a specialist.

In an advanced stage of the pathology, when there is a real risk of complications and in cases where therapy is powerless, treatment of valgus curvature of the limbs is provided surgically. Before such an intervention, the diagnosis is clarified using modern diagnostic techniques - computed tomography and MRI.

Valgus curvature of the legs in a child requires careful attention. Most of these disorders do not require special treatment and are eliminated with age. However, pathological deformations cannot be triggered. Their treatment at an early stage is ensured by a conservative method, but complicated forms lead to surgery.