Hallux valgus — causes and treatment of disease in children

Features of hallux valgus in children: symptoms, treatment and prevention

Valgus feet — a podiatrist’s diagnosis exposes some of the children of the first years of life. With the early detection and treatment the probability of complete correction of the foot approaching one hundred per cent, in advanced cases, the child in later life appears a lot of problems with the spine.

In the normal position in any person, including the child’s, feet are parallel to each other. During the Commission of the steps the parallelism is maintained, the main burden thus falls on the area under the toes and the heel.

With the development of hallux valgus in children load during walking accounts for the inner part of the foot, the outer thus raised, the little finger down to the floor, and is in «suspended» state.

The formation of valgus of the foot begins in the period when the child begins to walk, this is primarily due to the load on the legs. Especially important period in a few months once the baby has mastered walking.

It was at this time the prerequisites to incorrect formation of the foot and the lack of preventive measures can lead to advanced stage hallux valgus.

The causes of pathology

Hallux valgus may be congenital or acquired. Congenital abnormality is rare, more often the disease is detected in the second year of life. The main reasons for hallux valgus feet in children include:

  • Connective tissue dysplasia is the most common cause of pathology. The basis of the ligaments of the whole body is connective tissue, improper development leads to weak ligaments. In turn, weak ligaments cannot withstand the load of the entire spine to his feet.
  • The mismatched shoes. No heel, soft sole is not able to fix the foot, so it begins to bend in the slightest for her position.
  • Poor environment leads to disruption of metabolic processes that also affects the connective tissue.
  • Hallux valgus often shaped in preterm infants.
  • Incorrect position of the foot refers to the secondary manifestations of rickets, cerebral palsy, polyneuropathy. All these diseases are somehow connected with a dysfunction of neuromuscular fibers.
  • Genetic predisposition.
  • Overweight. The likelihood of pathology increases if a baby with large body mass starts walking early.
  • Weak immune system – frequent colds, bronchitis, pneumonia.
  • Injury, a long stay stop in the cast.

Classification

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Podiatrists use a certain classification of hallux valgus of the feet, based on the causes of disease:

  • Static develops during the formation of poor posture.
  • Structural associated with congenital disorders – the anatomically correct position of the talus.
  • Compensatory occurs under the influence of a shortened Achilles tendon at an oblique position of the tibia at the location of the tibia inwards.
  • Hypercorrection. This form of deformation due to improper treatment of kosolapy.
  • Spastic valgus deformity develops, the child is exposed to extensori muscle spasms that occur when the malfunction of the cerebral cortex.
  • Nerve is a complication of polio or encephalitis.
  • Rachitic is formed with rickets.
  • Traumatic. May lead to incorrect position of the feet fractures of the foot and ankle, torn ligaments. The axis of the limbs may deviate from the normal position when damage to the hip, knee, and hip joint.
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The degree of deformation

On the severity of the occurrence of the disease is divided into several degrees:

  1. The first is set in the deviation from 10 to 15 degrees. First degree valgus deformity responds well to adjustments and preventive measures.
  2. The second deviation from the norm of 20 degrees. An adjustment is a simple procedure.
  3. The third deflection angle to 30 degrees. The treatment is long lasting, but subject to all prescribed by a doctor manipulation successful.
  4. The fourth deflection angle exceeds 300. The ineffectiveness of therapy, surgical correction of deformity.

Symptoms

Parents may suspect a valgus deformity of foot in children by the following features:

  • in the standing position and with a clenched knees distance between ankles both stop increased to 5 cm or more;
  • the lower part of the legs resembles the X-shaped;
  • the outer part of the foot is raised, not in contact with the floor, and rests on the opposite inner flat horizontal surface;
  • casual shoes baby with one end of strain – worn-out inner part;
  • uncertain gait.

At the initial stage of development of the disease the baby does not experience discomfort when walking. Over time, the child begins to tire quickly, afraid to run as peers, complains of pain in her legs. When running it is noticeable that the child balances with his hands, trying to compensate for the instability of movements.

Diagnostic methods

In cases of suspected pathology of the foot should consult a podiatrist. The doctor preliminary diagnosis put on the basis of visual inspection, to confirm a number of surveys:

  1. podometry – method study aimed at identifying changes in the longitudinal position of the feet;
  2. radiography is performed in three projections. The children are currently doing rarely;
  3. computer plantography allows to evaluate morphological parameters of the whole foot;
  4. in some cases, shown the ultrasound diagnostics of joints;
  5. shown densitometry for suspected osteoporosis.

To exclude congenital or acquired pathologies of the Central nervous system a doctor prescribes examination by a pediatric neurologist. Also, you should visit an endocrinologist and surgeon.

Complex medical procedures

The main goal of treating hallux valgus feet in children is to restore normal anatomical position of the foot. At the first degree enough wearing orthopedic shoes, massage, and constant exercises, all this helps to strengthen the musculo – ligamentous apparatus.

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The identification of more severe degrees require long complex treatment.

Conservative treatment

Methods of conservative treatment include:

  • Foot baths are necessary to improve tone of muscles and ligaments. To prepare the bath will need salt in the amount of 1/3 Cup and 10 litres of warm water. In salt solution the child is planted on the belt for 15 – 20 minutes after bath, to bathe it is impossible, you only need to wash away the genitals. Trays are handled through a day, a course is 15 procedures. It is recommended to repeat the entire course every four months.
  • Paraffin wraps for the legs are done on the whole foot or as high boots. Paraffin therapy is performed in clinics, with sufficient experience, the parents of the physiotherapeutic procedures can be done at home.
  • Massage for hallux valgus is one of the most important points of treatment. A professional massage is recommended by a specialist. Stay at home mom can use the simple techniques of massage, after receiving instruction from the doctor. It is recommended to do a paraffin wrap and then into the softened muscle to massage.
  • From physiotherapy is also used electrophoresis, magnetic or electrical stimulation of the muscles of the foot.
  • Therapeutic exercises should be performed daily. Selected complex of exercises should be aimed at strengthening muscles and ligaments.
  • The use of special insoles and orthopedic shoes podiatrist will prescribe based on the degree of deformation. Wearing orthopedic shoes should be permanent, especially when expressed changes.
  • Useful for kids with hallux valgus swimming, Cycling.
  • At home you can use special massage mats and rollers.

Surgery

To surgery regarding the correction of valgus foot in a child is resorted to in rare cases and only with the ineffectiveness of all treatment activities:

  1. Dobbs method is to conduct manual correction of the feet, after which a plaster. To improve requires up to 6 sessions, held once a week, after each manipulation, the foot changes its position. Fixing plaster is performed from the middle third of the thigh and on the whole foot, the knee bent at an angle of 90 degrees. At the last stage, the doctor locks in the correct position of the talus – navicular joint. For bond used K-wire, inserted through the skin. Then again, a plaster for about two months, later wearing a plaster boots. After the plaster is removed to prevent recurrence it is necessary to wear a brace, special shoes fixed and placed at an angle on the plate. In the first week of treatment the brace is worn almost without lifting, subsequently they are recommended to wear at night-time and daytime sleep. Treated according to the method of Dobbs children in the future need special shoes with arch support.
  2. Arthrodesis operations are aimed at creating a fixed joint between the talus and the calcaneus, it allows you to strengthen the muscles of the inner arch. After surgery there may be pain when walking, so this surgery is rarely used.
  3. Modern surgery offers performing minimally invasive surgical procedures. The progress of the operation is to change the angle between some bones of the foot thereby increasing the tension of the ligaments.
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Rehabilitation after surgery

After conducting arthrodesis operations and surgical procedures according to the method of Dobbs ‘ recovery period can take up to six months.

During this time it is necessary to wear orthopedic shoes, braces, shock wave physiotherapy to strengthen the blood circulation in the feet.

After six months you can start to sports and normal physical activity.

Complications

Valgus feet in the absence of adjustment leads to:

  • flat feet;
  • the osteochondrosis and arthrosis;
  • constant pain in the legs;
  • violation of posture.

During long-term course without treatment increases the load on the entire spine and a child in the future suffering from many diseases musculoskeletal system.

Prevention of the disease

To prevent the development of hallux valgus stop is not so difficult. Parents should follow these guidelines:

  • You do not need to practice earlier circulation of the child. Put on legs recommended since 7-8 months a few minutes a day.
  • Definitely need the right shoes with the heels, a stiff heel and curving in the center of the toe sole.
  • Strengthening of the ligaments is carried out with the help of massage, gymnastic exercises. Baby well help in the proper formation stop training on the wall.
  • It is necessary to regularly undergo preventive examinations.

In cases of suspected incorrect position of the feet will need to go to the orthopedist, in the early stages of the pathology is corrected for a few months.

Video: How to determine the baby PLANO-valgus foot