Flat valgus placement of feet treatment. Valgus foot deformity in children. Symptoms and degree of impairment

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). At the same time, in the position of compressed knees, the gap between internal parties ankle length is about 5 cm.

What is this - individual characteristics foot problems in a child, congenital or acquired pathology, consequences of any disease or poor 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 further development total support - musculoskeletal system and lower extremities.

On early stage 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 characteristics structures 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

TO main reason This disease includes 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 for various reasons formation of disturbances in the position of the foot.

The causes of deformation may include:

• in the form of consequences of rickets, diabetes mellitus, pathologies thyroid gland;
• V birth trauma areas of the lower extremities, especially with displacement of the hip joint;
• in hereditary predisposition;
• in too heavy weight body that places 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 normal position feet at 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°, it is considered to the greatest extent development of hallux valgus. In this case, treatment is possible, but extremely difficult.

There is a possible situation in which therapeutic treatment turns out to be ineffective. In this case, resort to surgical removal 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 next cycle therapeutic 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 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, walking on different parts feet.

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 similar procedures don't take off pain, then it is possible to prescribe painkillers.
2. Changing the foot with surgical correction for valgus transformations of the foot in children, it is not often used. This is usually viewed as last resort if, for example, therapy did not give any positive effect, or the child received serious injury requiring radical intervention.

The phrase “surgery” sounds scary, especially for parents. Modern methods carrying out such events allows you 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 in 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. Intensity and strength massage movements depend on the degree of foot deformation.

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 the 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.

Of great importance general strengthening baby's body, because 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 by early period. 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 a good heredity, but also proper development at healthy way life.

Often, when visiting a pediatrician, parents hear about the deformity “flat valgus foot in a child.” In the future, all examinations will be carried out by a pediatric orthopedist, who will keep a medical history.

You can understand what the diagnosis of flat valgus alignment means by looking at the word itself. “Flat” means that the child’s foot is flat - this is obvious, but valgus means that the child’s foot is X-shaped. Many of us have met people whose legs are positioned in an X; in the case of our disease, only the feet are positioned in an X.

Orthopedists say that a flat valgus foot in a child is not a disease, but a deformity that is a consequence of weak ligaments. A child with this problem gets tired faster. Anatomically, the foot falls inward and as a result, the arches and vaults are not formed as they should be.

If plano valgus feet in children are not treated, then over time the problem will develop into flat feet.

Why is flat feet dangerous?

For many people, flat feet are just an excuse not to serve in the army. But those who have this defect know that, jokes aside, there are many problems.

The safest, but still unpleasant, is a cosmetic defect. And in the future it becomes difficult to find suitable shoes; you constantly have to look for a special manufacturer and special insoles.

Women cannot walk in heels; the heel slides forward, which leads to discomfort, spoils the gait and has an adverse effect on the spine. Over time, a lump may appear near the base thumb. This protruding bone not only spoils the appearance of the feet and interferes with wearing nice shoes, but also spoils a person’s well-being due to constant inflammation and aching pain. Therefore, you definitely need to pay attention and act on this.

When to see a doctor

U small child The flat valgus position appears as soon as the child gets to his feet on his own. The leg cannot withstand the load of the body, and the inner edge of the feet sags, and the front part is abducted. As soon as the first signs of X-shaped limbs appear, that is, the plano valgus sign, you need to consult a doctor for advice and purchase quality shoes.

The diagnosis of flat feet in a child most often occurs after the age of 3 years, and hallux valgus already at 9-12 months. Over time, these two problems combine into one, and the result is a flat valgus foot.

Flat feet are not common in children under 3 years of age as a disease. It is present in all children, but it is physiological, that is, it normal condition for this period of development. There is no characteristic indentation on the inside of the child’s foot, but there is still a layer of fat there that acts as a shock absorber. An orthopedic doctor can only pay attention to the shape of the child’s foot, if it is flat or wide, as a result, a flat valgus position of the feet may be detected.

Causes of the defect

The condition of the child’s feet and the formation of a flat valgus foot are influenced by:

• general muscle weakness child;
• decreased or increased muscle tone;
• protracted viral diseases;
• pneumonia;
• bronchitis;
• rickets;
• prematurity.

Flat feet and flat valgus curvature in children are a consequence of spraining the ligaments and muscles of the inner part of the foot, shin and ankle, the heel moves outward, the ankle inward, and the whole Bottom part legs changes centered position.

If the flat valgus position is strongly expressed, then it becomes difficult not only to perform physical exercise, but also just to walk. Depreciation is minimized, so the entire load falls on the spine and brain.

After 5 years, flat valgus foot placement in children is practically untreatable, so therapy should be started as early as possible. To begin with, flat feet simply stop and improve general state legs. And even if it is not possible to cure the child 100%, this deviation (if it is under control) will not affect his general health in the future. Based on the severity of the problem and age, the doctor prescribes orthopedic insoles, physical therapy and massage.

The importance of massage

Thanks to the massage, the child’s muscles relax, the ligaments stretch, they become stronger, the balance of forces is normalized, after which the foot takes the desired position, which is what is achieved during the therapy of the flat valgus foot.

The most important factor in the treatment of flat valgus foot in a child is exercise. physical therapy. It is not used in isolation, as it is aimed only at consolidating the result obtained. Using massage and exercise therapy in parallel, you can achieve lasting, long-term results.

As for the massage, the emphasis is on the inner and front part of the lower leg; on the foot, attention is paid to the big toes: it is important to improve their supinator functions.

When doing a massage, you should not put too much pressure on your legs; kneading, rubbing and stroking methods are used. When massaging the legs with a flat valgus foot, vibration, rubbing and stroking are used. Massage is done before and after gymnastics.

The process of correcting flat feet and flat valgus feet is long and complex, but if you continuously practice necessary procedures, then you can count on normalization of health and proper growth of the lower extremities.

Physiotherapy

Special exercises Exercise therapy for children, if there is a flat valgus position of the feet, can be performed at home. The child should perform the exercises in thin socks or barefoot; the whole complex is divided into several parts of 2-3 exercises and performed throughout the day. The main emphasis in flat valgus installation is directed towards correct positioning feet when standing and walking. Sometimes doctors, after certain examinations, prescribed salt baths and electrophoresis. It even happened that doctors strongly recommended a bicycle for flat valgus feet. And you know what, it helped.

Children's gymnastics leads to the fact that the child must learn to place his legs and feet in correct position, that is, close and parallel to each other, and not widely spaced, as with a flat valgus defect. If he had a flat valgus installation, then lower limbs will gradually fall into place.

To develop walking skills with flat valgus disease, it is recommended to walk on a path no more than 15 centimeters wide; it can be a strip of carpet or a board; if neither of these is available, you can draw boundaries directly on the floor with chalk. On the street, you can also drive your child along curbs, logs, etc.

The rest of the special exercises for flat valgus feet in children are selected directly by the doctor.

How helpful information, include in your child’s diet: turkey and rabbit meat, fish, and also products containing a large number of calcium, like cottage cheese and cheese. Very helpful fresh juices, zucchini, zucchini, celery, sesame seeds, etc. If possible, go with your child to specialized sanatoriums for faster and effective treatment feet. It will not only be relaxing, but also useful!

Valgus deformity foot problems in children are quite common. The main reason is weak articular-ligamentous apparatus. To prevent illness, it is recommended to encourage active games child, buy high-quality shoes that fit him, and not for his growth, give him a massage and wear orthopedic insoles. But if the child is small enough, then it is too early to worry, there is a high probability that the joints will get stronger and the problem will go away on its own.

Valgus deformity of the foot is expressed by a decrease in the height of the arch and curvature of its axis. At the same time, the heel and toes turn outward, and middle section goes down. The connected feet of the feet, when viewed from above, are shaped like the letter “X”. As a rule, if there is a hallux valgus in children, then wearing ordinary shoes becomes impossible due to the deformation of the foot and the associated aching pain.

If you notice one of the symptoms in your child, we advise you to visit an orthopedist, since only a doctor will be able to assess the severity of the disease and prescribe appropriate treatment for the child’s hallux valgus.

Occurrence and course of the disease

Valgus feet do not develop quickly; in the first stage of the disease, you may notice flat feet and a slight bend in the leg while walking. Further difficulties arise with the selection of ordinary shoes. The child may also begin to complain of pain in the legs, especially in the evenings. At the next stage of the disease:

• the first and second toes are deformed;
• the sole becomes denser, which causes painful calluses or corns;
• the second finger begins to bend, and a callus gradually forms on top of it.

If planovalgus foot deformity in children is detected in a timely manner, then it is possible full recovery joint functions and appearance stop.

A - valgus anterior section feet. B - balanced (“normal foot”). C - varus of the forefoot.

Causes of deformation

The main reason is congenital weakness of bone and connective tissues in the child. But others may also occur:

• endocrine disorders various types : diabetes, thyroid diseases and others;
• transverse flatfoot- absence of a longitudinal depression opposite the middle toe;
• Osteoporosis is a disease in which bone density decreases and their fragility increases;
• excess weight, as a result of which the child’s weak joint cannot withstand the load;
• foot injury;
• genetic predisposition.

Separately, it is worth noting incorrectly selected shoes. The problem is especially relevant for teenage girls: at this age it is unacceptable to wear shoes or boots with a heel higher than 4 cm and a narrowed toe. In this case, the load on the foot is not distributed evenly, and the main emphasis falls on the front part, contributing to the development of the disease. And treatment of flatvalgus feet in adolescent children is more complex than in younger children.

Valgus flatfoot in children of the first or second year of life has a different nature. The disease usually occurs when the child begins to walk. The reason is the large load on the joint-ligamentous apparatus when trying to walk, and then run and jump. Deformation on initial stage can lead to curvature of the ankle joint, and then to curvature of the spine and the occurrence of such “adult” diseases as arthrosis and osteochondrosis. There are cases when a child is diagnosed with “foot valgus” while still in the maternity hospital. The treatment of such a disease is very complex, but this form the disease is rare.

Treatment

An orthopedic surgeon can make a diagnosis and prescribe treatment for the disease. However, the appearance of the first signs of foot valgus does not mean that you need to actively begin treatment. A child’s foot is formed before the age of 10-12, so as they grow, the situation can change radically. At the slightest suspicion, it definitely won’t hurt to show the child to a specialist, and only he should prescribe treatment.

Conservative

Operational

If the disease is progressive, surgery may be required. Modern orthopedics provides “low-traumatic joint correction”; in this case, neither plaster nor metal structures are required. During the operation, the surgeon changes the angle between the bones of the foot, thereby correctly distributing the pulling moment of the ligaments. The child recovers quickly: a day after the operation he can already move independently, and the likelihood of relapses is extremely low.

Disease prevention

Factors to consider when purchasing orthopedic shoes for your child.

Hallux valgus can be prevented by following these simple rules:

• do not ignore a preventive examination by a pediatrician, and if he has some doubts and suspicions about the disease, be sure to visit an orthopedist;
• do not buy shoes to grow;
• Children's shoes must have an orthopedic insole and a small heel.

The choice of children's shoes must be approached with all responsibility, because they are the ones that can prevent the occurrence of the disease. Try to choose from natural materials, preferably leather. Before purchasing, carefully inspect the sole - it should be soft, and the place where it bends when folded should be on the toe, and not in the central part. Also encourage your child to walk on uneven surfaces: dirt, sand, grass, pebbles.

In conclusion, one more piece of advice that will help not only in the prevention of hallux valgus, but also in general physical development for your child - install a wall bars at home. Exercises on this apparatus strengthen the main muscle groups and keep the body in good shape!

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This pathological change in the direction of the axes of the lower limb predisposes to flat feet. Gradually, with regular exercises and medical procedures, the position of the heel can be adjusted, forming the correct position of the legs; if hallux valgus in children is not treated, this can lead to irreversible changes in the musculoskeletal system. Pathology therapy takes a lot of time and effort, but with daily work The baby will be rewarded with a beautiful gait and correct arch of the foot.

What is foot valgus in children?

A foot defect, which is characterized by a decrease in the height of their arches and an X-shaped curvature of the axis of the limbs, is called “valgus position of the feet in children.” With this pathology, children experience outward turning of the heel and toes, drooping of the middle part of the foot, and clumsiness in gait. If a child straightens and squeezes his knee joints, the distance between the inner sides of the ankles is no more than 4-5 cm. In this case, the internal arches “collapse” inward.

At what age does it appear?

All newborns have flat feet - this is the norm, since babies cannot walk yet, and the ligaments, bones and tendons have yet to learn to bear the load. As a child begins to stand, put weight on his feet, and walk, his feet develop and become stronger. When the arches do not have a formed structure or their for a long time is not visible at all, doctors make an intermediate diagnosis of “valgus foot deformity.” Changes become noticeable at about 1-1.5 years.

When is it necessary to see a doctor?

At the first signs that indicate that hallux valgus is manifesting itself, you should urgently show the child to the doctor, since the pathology tends to progress. If the disease is not treated, the situation will worsen, causing more serious problems to develop. The doctor will assess the child's health and determine what therapeutic measures will be optimal. As a rule, to fix the problem use conservative methods, and surgery is rarely resorted to, only in advanced cases.

Planovalgus foot deformity in children - causes

The pathology may be acquired or congenital in nature. In some cases, the parents themselves contribute to the formation of hallux valgus in children, trying to put the child on his feet as early as possible in order to teach him to walk. At the same time, the baby’s weak musculoskeletal system is not yet ready for such loads, as a result of which deformation processes develop. A child should take his first steps at the age when his body is stronger and ready for it (at about 10-12 months).

Congenital

Can provoke the appearance of pathology genetic disposition or any problems during pregnancy. Congenital hallux valgus in children is usually diagnosed by doctors in early age child (in the first months of the baby’s life). The most dangerous varieties congenital pathology Rocking foot and vertical ram are considered. When making a diagnosis of this type, surgical intervention is required.

Purchased

A foot defect can appear due to insufficiency, underdevelopment of the tendons and ligaments of the legs; in addition, the cause of hallux valgus is sometimes the child’s decreased muscle tone. A baby's legs may develop incorrectly due to the following factors:

• prematurity;
• overweight newborn;
• fetal hypotrophy;
• scoliosis;
• polio;
• rickets;
• teaching a baby to walk at too early an age;
• congenital weakening of connective tissues (formed in utero);
• muscular dystrophy;
• dysplasia;
• long-term stay of the leg in a cast after an injury;
• diabetes;
• hypothyroidism;
• polyneuropathy;
• past infectious and viral diseases;
• improperly selected shoes (without sufficient heel support, too soft);
• congenital dislocation of the hip.

Symptoms of the disease

When hallux valgus occurs, parents notice characteristic symptoms diseases, as a rule, only occur when the baby begins to take his first steps. Moreover, in most children, as they acquire walking skills, the symptoms of the deviation disappear. It’s another matter if the baby has been walking independently for a long time, but signs of the disease remain. IN in this case The child must be shown to a doctor. The most common symptoms of a sprained ankle are:

• the baby does not step on the entire surface of the foot while walking, but only on its inner arch;
• clumsiness in gait is noticeable;
• the child gets tired from walking;
• the baby's steps are uncertain;
• the shape of the foot is X-shaped;
• shuffling is heard when walking.

What does a hallux valgus look like in a child?

If your baby's feet are positioned incorrectly, you may notice certain deviations, for example, a change in the position of the toes and heels during bending (they seem to be looking outward). In this case, the middle part of the foot sags, as a result of which the position of the leg is unnatural. Children with hallux valgus have bowed legs due to deformation knee joints: if they are brought together, the inner edges of the ankles remain at a relatively large distance from each other (4-5 cm).

Valgus curvature occurs as a result of deformation processes and ends with the formation of flat feet and other deviations of the musculoskeletal system. The problem can be noticed if you look closely at the baby’s legs: with the knees together, they are bent in an X-shape. In most cases, this pathology is congenital, and in the youngest it goes away on its own, since it indicates insufficient development of the musculoskeletal system.

If by the age of 5 the problem remains, there is no reason to hope that it will go away on its own, since the child’s legs level out by this age. With later valgus, the child requires specialized and timely treatment, otherwise the disease will lead to deformation of the knee joints, and then the pelvis, which can cause curvature of the spine and others. serious problems with the back (osteochondrosis, vertebral deformity, etc.).

Stages of pathology development

Impaired development of the limb gradually progresses without treatment. The following stages of the disease are distinguished:

1. Light form. The deviation is no more than 10-15 degrees from the norm. This stage of valgus can be easily corrected using special orthopedic insoles and shoes.
2. At the second stage, the deviation in the position of the legs is 15-20 degrees, and therapy should include a set of conservative and therapeutic measures.
3. At the third stage, there is a noticeable inward deviation of the joint by 20-25 degrees. Therapy in this case is complex and long-term.
4. A severe degree of hallux valgus is characterized by a deviation exceeding 30 degrees. Treatment includes conservative methods; therapy is not always effective, so the child undergoes surgery.

How to diagnose hallux valgus in a child

Foot valgus is diagnosed through a careful examination by a local pediatrician, but to confirm the diagnosis, the child must be shown to an orthopedic specialist. As a rule, a number of additional studies are prescribed for this purpose:

• Ultrasound of joints;
• X-ray in three projections;
• computer plantography;
• computer podometry.

Computer plantography

Using this diagnostic study morphological parameters of the feet can be calculated. The procedure determines the pathology based on the imprint of the foot. The child is placed on the glass of the floor scanner with bare feet, after which the scan is performed. As a result, the orthopedist sees an image on the computer screen, from which he can assess the condition of the feet. little patient and make a diagnosis.

Computer podometry

The procedure is necessary to assess how evenly the load is distributed across the foot. Computer podometry provides an opportunity to identify pathological changes in cases where the baby has not yet manifested Clinical signs hallux valgus deformity. For clarification purposes, a pediatric orthopedist may prescribe an additional ultrasound of the joints.

X-ray of feet

The diagnostic method helps determine the location of the feet relative to each other. Radiographs show a decrease in the height of the arch of the foot, a violation of the location of the rear, front, and middle parts of the foot relative to each other. In addition, this diagnostic method helps to identify deformation of individual bones in the tarsal joints.

Ultrasound of joints

Under some conditions, an ultrasound of the joints is required. The study is carried out in supine position patient, while a cushion is placed under his lower limbs. The ankle is lubricated with a special gel, which provides good contact sensor with skin. The device emits high-frequency pulses, thanks to which tissue is visualized on the ultrasound machine screen. This diagnostic method helps to study:

• shin bones;
• ankle joints;
• calf muscles;
• ligaments

Treatment of hallux valgus in children

If therapy for the pathology is not started in a timely manner, the child develops flat feet and other musculoskeletal disorders occur. The purpose of treatment plano-valgus foot is to restore its normal form and functions. In addition, with the help of certain physical procedures and gymnastics, ligamentous and muscle tissues are strengthened. In the presence of an acquired form of the disease, children are given massage courses from the very beginning of therapy, foot baths, paraffin therapy procedures, electrophoresis, electrical stimulation, magnetic therapy, etc.

Plaster casts for congenital deformities

To treat clubfoot in children, it may be necessary to immobilize the limbs using plaster casts. Modeling and selection of material is carried out by a pediatric orthopedist, who takes into account the type of curvature of the foot and the degree of deviation from the norm. Staged plaster casts are used for severe deformity or if soft bandaging does not bring the expected effect. Initially, a circular plaster cast is applied, fixing the ankle and foot in a position for slight correction of the curvature.

When applying a plaster cast, the doctor great attention pays attention to shaping it to the protrusions, deepening the lower leg and foot. At the same time, the fingertips should remain free so that they can be used to monitor the state of blood circulation. After 5-7 days, the bandage is removed and manual correction of hallux valgus is performed. Afterwards a new clamp is applied to secure it achieved result. The procedures are repeated until the hallux valgus is completely corrected.

Foot baths and therapeutic swimming

For foot correction and arch formation correct form, the baby is recommended to go swimming. If you can’t go to the pool, you can do certain exercises yourself at home in the bathroom. Walking and jumping on a textured mat, which stimulates the sensitivity of the soles, helps strengthen the musculoskeletal system, and reduces the load on the limbs, would be suitable. Once a week, experts also recommend taking a warm pine-salt bath.

Massage for hallux valgus in children

This treatment method has restorative effect, improves muscle tone, increases joint mobility, promotes healthy neurological development. Held massotherapy in the following way:

1. Start with general massage body, alternating stroking, shaking, light tapping, rotation in the joints. Each limb should be massaged in turn, lightly stroking along the ribs, and the stomach should be massaged clockwise. Circular movements of the knee, hip, ankle joints. Afterwards, you need to turn the child onto his tummy and perform a back massage according to the principle described above.
2. Next, a foot massage is performed. Its main purpose is to activate blood circulation and tone the leg muscles. It is recommended to carry out the procedure twice a day (in the morning after the baby wakes up and in the evening after bathing). Start with light stroking of the feet, paying great attention to the big toes and the muscles around them. Lightly pressing and kneading each part of the foot, move on to the inner flattened arch, where they do light tapping and stroking.

Physiotherapy

The therapeutic techniques listed below are used as auxiliary ones. They activate metabolic processes in tissues and improve the supply of nutrients to them. The choice of physiotherapeutic procedures is made by the doctor, while maximum efficiency differ:

• Electrophoresis. During the procedure, the medicine is delivered directly to the desired area without the use of an injection or oral medication. Medicine applied to special napkins or a bandage, which is applied to the leg. Afterwards, the specialist connects electrodes that conduct current with a certain frequency and power. The procedure takes from 3 to 10 minutes (the duration depends on the severity of the pathology).
• Magnetotherapy. Treatment involves affecting joints, ligaments, muscles and bone tissue magnetic fields. The procedure is carried out using special installation, capable of moving a magnetic field. Magnetic therapy helps increase sensitivity to medications. The duration of the procedure is up to 20 minutes.
• Paraffin therapy. The legs are covered with paraffin, and not only the feet, but also most of the lower leg are treated. Paraffin therapy is carried out in clinics, but the procedure can also be done at home.

Physical therapy exercises

To correct heel deviations, Dr. Komarovsky and other experienced pediatricians advise performing exercise therapy. Exercises for correcting hallux valgus deformity are very simple. The main condition for achieving positive result– work with your child regularly. Special exercises to eliminate pathology:

• bend and straighten your toes in a sitting position (30 seconds);
• rotate your feet clockwise, then counterclockwise (30 seconds);
• standing, roll from toes to heels (1 minute);
• rising on your toes, stretch your arms as high as possible (40 seconds);
• grab small objects with your toes (2 minutes);
• bringing your socks together, spreading your heels and vice versa (2 minutes);
• rolling a small ball with your soles (1 minute).

Surgical correction

Surgery for hallux valgus is extremely rare (only in 7% of cases). Surgical intervention may be assigned to individually with severe severity of pathology. The most common surgical treatment methods are:

• transfer of the peroneus longus tendon to the inner part of the foot with lengthening of the Achilles tendon;
• application of an external foot fixation device;
• arthrodesis of the talonavicular joint.

Wearing orthopedic shoes

Children with foot disease must wear therapeutic orthopedic shoes, which are selected individually. Its peculiarity lies in fixing the foot with the help of special insoles, arch supports, a small stable heel and hard backs. The right shoes are chosen not by parents, but by an orthopedic doctor, who talks about the duration of wearing them (with constant use of orthopedic shoes, muscles can atrophy). In case of hallux valgus, shoes must meet the following requirements:

• correct sole, Thomas heel, inner part which is slightly longer than the outer one;
• soft top edge;
• comfortable fasteners that secure the leg well, but do not injure it;
• the back and sides should be relatively rigid and high to ensure fixation of the ankle and talocalcaneal joints;
• smooth surface of the insole;
• genuine leather outside and inside.

Prevention of hallux valgus and prognosis

Valgus of the feet can progress to severe stages, expressing itself not only as a cosmetic defect, but also causing functional disorders limbs up to disability at a young age. To avoid this, children under 7-8 months should avoid putting stress on their lower limbs. In addition, the following preventive measures are recommended:

• compliance with a rational regime;
• good nutrition;
• gymnastics;
• hardening;
• good sleep;
• taking vitamin D and all necessary microelements;
• regular, timely visits to the pediatrician;
• choosing the right boots (even healthy babies wear shoes with orthopedic insoles).

How to make an orthopedic mat for a baby with your own hands

Wonderful preventive and remedy for valgus and flat feet is a massage mat. Children perceive classes on it as a game, so children willingly perform the necessary exercises. You can make an orthopedic mat like this:

• small stones (pebbles) are thoroughly washed and dried;
• cut out a piece of carpet (preferably with a rubber base) of such a size that the baby can take 3-4 steps in each direction;

– a defect characterized by a decrease in the height of the arches of the foot and an X-shaped curvature of its axis. Hallux valgus causes outward turning of the toes and heels, drooping of the midfoot, clumsiness of gait, increased fatigue and pain in the legs. Diagnosis of hallux valgus deformity is carried out by a pediatric orthopedist based on external examination, radiography of the feet in 3 projections, plantography, podometry. Treatment is carried out with with the help of physical therapy, massage, wearing orthopedic shoes, applying orthopedic splints; if ineffective, surgical intervention is performed.

General information

To exclude pathology of central and peripheral nervous system children should be examined by a pediatric neurologist.

Treatment

The goal of treating hallux valgus in children is to restore its normal shape and function, strengthen the muscular and ligamentous apparatus.

With congenital hallux valgus deformity, it may be necessary to immobilize the limbs using plaster casts. The selection and modeling of the bandage is carried out by a pediatric orthopedist, taking into account the type of deformation and degree of deviation from the norm.

At the next stage (and in the case of acquired hallux valgus - from the very beginning), it is recommended to carry out foot baths, massage courses (lumbosacral region, leg joints, feet), paraffin therapy, ozokerite and mud applications, electrophoresis, diadynamic therapy, magnetic therapy, electrical muscle stimulation shins and feet, IRT. Therapeutic swimming and exercise therapy are useful.

Children with hallux valgus require the selection of individual functional insoles or special orthopedic shoes with rigid lateral fixation of the foot and heel and arch support.

TO surgical treatment resorted to relatively rarely (about 7% of cases). The method of correcting hallux valgus is determined individually, taking into account the characteristics and severity of the pathology. The most widespread methods in pediatric orthopedic traumatology are transplantation of the peroneus longus tendon to the inner edge of the foot with lengthening of the Achilles tendon; arthrodesis of the talonavicular joint, application of an external fixation device, etc.

Forecast

Hallux valgus in children can reach severe degrees, being not only a pronounced cosmetic defect, but also causing functional impairment of the limb, up to disability at a young working age. In case of low degree of deformation and timely treatment full restoration of foot function is possible.

Prevention

To avoid the development of hallux valgus in children, the load on the child’s lower limbs should be avoided until the age of 7-8 months. It is necessary to adhere to a rational regimen, including hardening, gymnastics, preventive massage, good nutrition, adequate sleep and walks. Important has prevention of rickets, intake of vitamin D and microelements.

It is mandatory to regularly visit a pediatrician, as well as preventive examinations carried out by specialists in various fields (including a pediatric surgeon and an orthopedist). Serious attention needs to be paid correct selection shoes for a child: they should be the right size (neither small nor large); made from high-quality natural materials; have a tight instep support, rigid back and sides.