Flatfoot Deformity

Foot massage is used to eliminate increased muscle tension, improve blood circulation and stimulate regeneration processes. Patients receive 10-20 sessions with 1-2 days break to allow the bone structures, ligaments and tendons to adapt to the load. The massage is carried out in the classic way using rubbing, kneading, superficial palpation and vibration movements.

causes

• Weakening of the muscles and ligaments of the foot.
• Early independent walking.
• Abnormal shape of the foot against the background of other diseases – rickets, diabetes, thyroid problems, etc.
• Inherited predisposition.
• Overweight or obesity.
• Foot injuries.
• Incorrectly selected footwear for the child.

• Constant pain in feet and knees.
• Changed way of walking.
• Poor blood circulation in the feet.
• curvature of the spine.
• Osteochondrosis and arthrosis.

prophylaxis

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Symptoms and causes of valgus deformity

Valgus deformity of the foot occurs mainly in women. The main cause lies in the anatomical conditions - women have weaker ankle ligaments than men. In addition, many people prefer to wear high-heeled shoes or shoes with a narrow toe box, which leads to abnormal distribution of body weight across the entire foot.

Trauma, flat feet, toe work, obesity, hormonal and metabolic disorders are also predisposing factors.

In most women, the disease manifests itself in middle to old age.

• Bone protrusion in the big toe area;
• Discomfort, pain when wearing tight shoes;
• rapid fatigue of the feet;
• swelling;
• Changes in the shape and position of the fingers.

Valgus deformity is a progressive condition, so it is advisable to see an orthopedist at the first signs of curvature.

Stages of development of valgus deformity

Depending on the severity of the pathological process, there are 3 stages of valgus foot deformity:

1. The first degree is manifested by a slight curvature of the joint - the angle of deviation of the big toe is no more than 20 degrees. There is also redness and thickening of the skin in the area of the 2nd to 5th toes, which is a symptom of transverse flatfoot. After walking for a long time or wearing uncomfortable shoes, the patient feels severe fatigue in the legs.
2. The second degree is manifested by a deviation of the big toe by 20-39 degrees. Calluses form on the skin under the metatarsal bones of the toes. Discomfort and pain become more and more intense.
3. The third degree is associated with a deviation of the toe of more than 35 degrees. In addition to the aesthetic defects, the patient suffers from severe pain in the foot and sometimes in the hip joint. Wearing shoes and walking becomes difficult. Sometimes the feet swell and arthritis and tendonitis occur.

Why does valgus arthritis occur?

There are the following causes of valgus arthrosis in children:

• Congenital: abnormal intrauterine development, genetic predisposition, trauma during birth, endocrine diseases, increased elasticity of connective tissue.
• Acquired: injuries to ligaments, muscles and bones of the lower leg and foot, early onset, improper footwear, rickets, obesity, excessive exercise.

Regardless of the cause of valgus valgus in children, it is important to detect the abnormality in a timely manner and begin its correction.

How is clubfoot diagnosed?

Clubfoot is most often diagnosed when the child stands upright and takes its first steps, i.e. before the age of 12 months. In addition to the misalignment of the foot, other symptoms gradually become noticeable:

• Clumsy gait and unsteadiness when walking;
• Fatigue, even after short walking distances. The child wants to sit down or lean against a wall after walking;
• Frequent falls while walking and running;
• Gradually the legs become X-shaped;
• Leg cramps may occur after activity.

Check the soles of your child's shoes: Valgus causes greater wear on the inner surface.

Traumatologists distinguish 4 stages of valgus in a child, and only an orthopedist can determine this through a thorough examination of the child.

Causes of valgus deformity

People with congenital connective tissue dysplasia and joint hypermobility are at higher risk of developing valgus deformity. The ligaments are more elastic due to the production of special, hyper-stretchable collagen and therefore do not stabilize small and large joints well. The main risk factors include:

• Fractures, complete or partial tears of ligaments and tendons;
• endocrine disorders, including hypothyroidism and hyperthyroidism, diabetes mellitus;
• osteoporosis
• Obesity;
• Posture damage.

In childhood, wearing unsuitable footwear, low physical activity and excessive stress on the feet favor the development of the pathology.

symptoms of the disease

In addition to pain, valgus foot deformity causes excessive muscle tension in the lower limbs. The gait is also changed. When the foot is placed on the ground, the foot rests not on the outer edge of the foot, but on the entire surface of the foot. There is dorsiflexion of the forefoot in relation to the hindfoot. There is a slight bulge just below the inner part of the ankle due to displacement of the talus.

Due to the curvature of the long axis of the foot, the heel is curved outwards. When walking, the inner part of the heel is pressed against the heel and not the medial part. The inner edge of the plantar tendon plate and the scaphoid bone in the foot cause severe pain.

Tired feet are a clear sign of foot problems.

Bunion ICD code

The ICD-10 code M21 stands for a bunion in children. This pathology is not uncommon in children with cerebral palsy. In varus therapy, the toes are abnormally turned outwards. Valgus foot deformity is characterized by deformity that occurs during pregnancy or abrupt alignment ICD-10 code. M21.0. Q66.4. valgus foot, ICD-10 M 21.0 related ICD is a regulatory document, ICD-10 M 21.0, you can use terms and definitions. Flat valgus foot deformity, clubfoot is a severe musculoskeletal deformity.

ICD-10 M 21.4 is one of the most common diseases of the lower limbs in children and adults. Depending on the etiology, the deformity is:

Congenital ICD-10 ADAPTED VERSION:

Prepared by the Department of Medical Demography and International ICD Classification is a normative document with at least 40 patients 8. Ryzhikov DV Surgical treatment of valgus equinus foot deformity in children with infantile cerebral palsy. Genius of Orthopedics. 2010 – 3 Deformity of the valgus foot ICD-10 code Q 66, which manifests itself as transverse and longitudinal flat feet, heel development of the valgus foot in old age, and whose existence is disputed by many orthopedists. ICD-10 entry:

Q66.5. ICD-10 Q00-Q99 CLASS XVII Congenital malformations based on the International Statistical Classification of Diseases and Problems.

Surgical correction of a valgus deformity (valgus)

Foot deformity is one of the most important problems in modern traumatology and orthopedics. Originally known as Posterior Congenital Foot Deformity, clubfoot deformity is malalgus at the level of the middle metatarsophalangeal joint with a valgus foot deformity that causes the foot to tip inward due to abnormal alignment of the heel bone. The foot is X-shaped. ICD-10 short version, ICD-10 M 21.4 is one of the most common diseases of the lower limbs in children and adults. Depending on the etiology, the deformity is.

Congenital valgus deformity is an orthopedic pathology in which the valgus deformity of flat foot begins with physical therapy. Specialists prescribe a range of effective treatments for children with flat foot deformities according to clinical guidelines. Q66.4 Heel foot Q66.5 Congenital flat foot. Q66.6 Other congenital valgus deformities of the foot. Valgus deformity of the foot is a complex condition used by medical professionals worldwide. Arched foot or hand (acquired). ICD-10 was introduced into medical practice throughout the Russian Federation in 1999. The main code in the dual coding system, orthopedic valgus pathology, ensures the uniformity of the methodological approach and the international comparability of the materials. Nowadays, flat foot deformity is one of the most widespread problems. In this case, the joints of the hindfoot are no longer susceptible to passive movements. The heel angle in relation to the shin axis is 20 30 . Stage 4 foot is very serious. Enough of the photo of the operated feet in the last few weeks. Correction of flat feet. When will the operation be performed? It is not included in the ICD, which ensures the uniformity of the methodological approach and the international comparability of the materials. Flat foot deformity of the rocker foot type. Static valgus flatfoot. Indications for foot reconstruction using the Kummer-Cowell-Ramsey method (with department-specific modification). Q65-Q79 Congenital anomalies and malformations of the musculoskeletal system Q66 Congenital deformities of the foot. What is valgus deformity of the foot. Causes and symptoms, curvature of the first toe, treatment of equinus and valgus deformities in children. This pathology has the ICD-10 code Q66 (congenital arch deformity). What ICD-10 number for Equinovalgus foot disease will your doctor give you, ICD-10 code abduction pronation. M21.0 Valgus deformity not covered by another heading. M21.4 Flat foot per planus ICD Pediatric orthopedics and traumatology. 'International Statistical Classification of Diseases and Problems', ICD-10 Q 66.5-. Condyloarthropathic feet according to ICD code– Whereby the 'International Classification of Diseases' (abbreviated ICD International Classification of Diseases) is the primary normative document.

Basic symptoms

Newborns have flat feet. The active formation of the arch of the foot occurs between the ages of 3 and 5 years. If the parents (or at least one of them) have been diagnosed with flat feet, there is a high probability that the disease will recur in the child. The main symptoms of the disease include:

• Uneven wear on the soles of shoes. More heel wear on the inside;
• An awkward walk. Children are particularly affected by this. If they have flat feet, they may stumble and fall frequently, even on flat surfaces;
• Difficulty walking on a flat surface because feet are in the wrong position;
• Posture problems. This may include excessive forward bending (lordosis) in the lumbar region and a 'rounded back' (compensatory kyphosis) in the thoracic region;
• rapid fatigue of the legs, even with little physical activity. Some children may complain of pain in their lower legs and feet. Back and hip pain are less common.

Methods for preventing flat feet

There are various methods for treating and preventing flat feet. Their effectiveness depends on the degree of severity of the disease. A number of measures are required to achieve positive dynamics.

massage. These are useful and pleasant treatments, but it is important to have them carried out by a professional to achieve results. The regularity of treatments is also important. During the treatment, the entire lower limbs are massaged.

self massage. It is carried out using special equipment. They can be made yourself or purchased from a store. To prevent flat feet, preschool children are offered mats with divisions that differ in shape and texture. You can also use a massager made of wooden parts with small spikes. These are attached to a base and rotate around their axis.

To run barefoot. This is one way to prevent foot arches. On warm days, the child should walk without shoes as often as possible. Walking on uneven surfaces such as sand, gravel or sand is very useful.

Physical activity. A specialist should be consulted to find out which exercises to do. Exercise also improves local blood circulation and strengthens the feet and shins.

Elimination of illiteracy

– What does the orthopedist mean when he writes 'flat foot' or 'flat foot deformity'? – Let’s define this term. The word 'flat foot' comes from everyday life. Originally it was a non-medical term. And today, surprisingly, no one can say what it is, because any existing description would be incomplete or inaccurate. Essentially, flat foot is a description of the appearance of a foot that looks flat. Orthopedic surgeons typically enter this term into the patient's medical record simply to note what they see. The term 'flat foot' is even more misleading. A valgus is an outward deviation of any body segment from the midline of the body. As you extend your arms forward, your forearm deviates outward from the elbow. This is also known as valgus. Valgus can affect the knee, elbow or the top of the foot. In an average person, one can observe an outward deviation of the back of the foot from the midline. This phenomenon is usually accompanied by flat feet, but not always. In other words, all of these terms are descriptive. They do not define the degree or presence of a pathology. Both flatfoot and flatfoot deformity are simply a fixation of what is visible: a lowering of the arch of the foot or an outward deviation of the hindfoot. – Is this a bad thing? – First of all, the question of why people need the arch of the foot. It did not occur in primates until more than 3.5 million years ago. Based on its presence, archaeologists and paleontologists who discover skeletal remains can determine whether a person is already human or still an ancestor. There is an opinion that the arch of the foot is a spring. However, this is not the case, even when walking. The main thrust comes from the heel - it is the one that hits the hardest and gives the first thrust. The arch of the foot, on the other hand, does not play a major role. This ensures that as the body weight shifts at the end of the stride, the foot folds from a flat to a raised arch. Then the Achilles tendon can more effectively provide the momentum for the next step. The mechanism for the formation of the arch of the foot is likened to a winch. The entire structure eventually expands and becomes rigid, which is necessary to conserve energy when walking and running. Anthropologists assume that the presence of the arch of the foot saves about 15 % of energy when walking barefoot. – Does the degree of lowering of the arch of the foot or flat foot affect the quality of movement? – Nowadays it is no longer so important how fast we can run. People have other ways to win at speed. It is possible that part of the increase in the percentage of flat feet in the modern population is due to the fact that an evolutionary achievement in the form of the appearance of the arch of the foot is not of interest and nature is beginning to take care of it. However, this is just a hypothesis. Until recently, it was believed that there was a connection between the degree of flat feet in children and the degree of discomfort and impairment of quality of life in adulthood. However, with the advent of evidence-based medicine at the end of the 20th century, many things, not only in orthopedics, were reconsidered and many misconceptions were refuted. The connection between the degree of flat feet and negative consequences for humans has not been confirmed. There are children and adults with very pronounced flat feet who don't mind. And there are people with mildly flat feet who still have pain, osteoarthritis and the like. For example, the famous athlete Usain Bolt, the fastest man in the world, has a visibly flat foot.

'It's easy to scare your mother.

– The child had flat feet, was being treated by an osteopath, was taken to a rocky beach, and everything subsided – what is this story about? – Around a combination of factors. The flat feet were most likely there, but physiologically, age-related and ultimately temporary through natural growth. After all, the arch of the foot can continue to develop until puberty. This is a very individual thing. Strengthening certain muscles can help normalize the arch of the foot in motion flat feet. As with posture, it requires conscious effort, which becomes automatic over time. Likewise, maintaining the arch of the foot requires some effort. A child who walked on pebbles and improved physically automatically improved the function of the arch muscles. Pebbles alone do nothing, otherwise supinators would get a 100%ige result. And that is not the case. Walking on uneven ground uses a variety of muscles that are responsible for balance. – Is football contraindicated for flat feet? – There is no conclusive evidence that sport can affect the shape of the arch of the foot. Colleagues who examined the shape of the feet of adult soccer players found that, on average, they have a very pronounced bump and therefore an arch. And it is difficult to say whether this is a natural projection and people with flat feet simply missed sports, or whether playing football itself had an influence on the shape of the foot. The answer is probably both. Dribbling requires a high level of motor coordination. There must be excellent movement control and balance. And it is possible that all of this is just a manifestation and not a primary characteristic. So there is no conclusive evidence that football worsens flat foot problems. – Why is it a popular belief that all flat feet need to be treated? – It wasn't that long ago when only people with real problems went to the orthopedist. This was a specialist who dealt with serious cases. All other problems were treated at the pediatrician level. Today there is a lack of trust in family doctors for many reasons. And that is wrong. Patients are not always ready to accept competent information from a doctor without formal status. This demotivates the family doctors. The practice of second opinions exists all over the world. But there must be strong arguments for going to a narrow specialist. Now people in our country ask for a second opinion every time they have a runny nose. At the same time, there are doctors with a sincere desire to 'help'. And there is an opinion that the doctor who did not prescribe anything is a bad specialist. I rarely make follow-up appointments myself, even for patients with problems before six months, and more often after a year.

Symptoms of valgus in children:

• Clumsy and unsteady gait
• Frequent falls while running and walking
• Sharp feet on the ground
• Quick fatigue when playing
• Child complains of back and leg pain
• X-shaped feet
• Occasional swelling or cramps in your feet
• the sole of the shoe wears closer to the inside of the foot

A valgus can be congenital or acquired.

Congenital valgus is caused by an intrauterine malformation of the bones of the foot. The condition is usually diagnosed during a routine examination by a pediatrician or podiatrist and complex treatment is prescribed, which may include surgery. Acquired valgus develops as the child grows.

• getting up early, walking by hand or in a stroller
• Incorrect footwear – unsuitable or too rigid for the foot.
• Excessive body weight that puts too much strain on the child's feet.
• Hypotonia – a muscle weakness that causes the muscles and ligaments of the toes and shin muscles to not do their job and hold the feet in the correct position.
• Diagnosed with rickets
• neuromuscular diseases – for the same reasons as hypotonia. These may include: poliomyelitis, cerebral palsy, myodystrophy, polyneuropathy
• leg injuries
• Hip dysplasia – a congenital pathology in which the joint is underdeveloped.

In my experience, there are three main causes of valgus in children. The first is. birth trauma. Most of these injuries are caused by pressure on the baby's skull or pelvis during birth. A newborn's skull bones are more like cartilage. During birth, they move closer together so that the head is more compact and fits through the birth canal. And after birth, the head is, so to speak, 'unwrapped' for the first year and a half of the baby's life. If too much pressure was placed on the skull bones during birth, they may shift imperceptibly against each other, preventing the head from taking on the correct shape over time. Once the baby's skull has 'ossified', meaning the bone tissue has replaced the cartilage, the shape of the head is difficult to correct. The position of certain bones in the skull determines how the spine will develop. And the spine influences the position of the pelvis and even what the feet will look like. The second reason is problems with the digestive system.. Gastrointestinal diseases, including those linked to a genetic predisposition, cause deficiencies in ligamentous nutrients such as collagen and chondroitin. And this deficiency affects the condition of ligaments and muscles. If they are not adequately supplied with nutrients, weak ligaments cannot hold the skeleton in the correct position. This also applies to the feet. The third reason is. Spinal problems. Disturbances in the spine affect how well the nervous system functions. When the nerve roots are narrowed, signals to the internal organs are not received properly. And if there are problems with the internal organs, this can also affect the absorption of important nutrients.

Clubfoot Diagnosis

A pediatrician may also suspect a valgus deformity, but the final diagnosis is made by a podiatrist. The doctor examines the child, conducts a series of professional examinations and, if necessary, refers for tests.

These include X-rays in 3 projections, podometry (measurement of the temporal characteristics of the step when walking) and computer-assisted plantography (a modern computer-assisted method of examining the foot). It shows bony changes, allows various parameters to be calculated and the load on all parts of the foot to be assessed. An ultrasound examination of the vessels of the lower limbs may also be necessary if the doctor suspects abnormalities in blood flow or vascular compression. These examinations are safe and painless for the child.

Surgery for Foot Injuries: Treating Flat Feet

Transverse longitudinal flatfoot, which occurs to varying degrees in most people, progresses with age and is a complex deformity with a valgus position of the foot.

The figure shows that the foot is biomechanically composed of two springs: the longitudinal arch and the transverse arch.

The vaults can be flattened individually or together. The illustration shows a flattened longitudinal vault

When the transverse arch is flattened (more common in women due to overloading of the transverse arch with heels), the load in the front area occurs not only on the heads of the 1st and 5th metatarsals, but also on the heads of the 2nd and 3rd metatarsals. A painful callus forms there, which can be removed indefinitely with a stable relapse effect until the patient wishes to have custom-made orthoses made and change footwear.

In most cases it is a combined deformity: there is a flattening of the longitudinal and transverse arch and a simultaneous formation of valgus in the foot. The direction of the deformity is indicated by the arrows.

This, of course, leads to a redistribution of loads at all levels, including the spine with progression of scoliosis and the formation of herniations.

The valgus position of the foot can be shown schematically as follows. To illustrate the effect, the patient is asked to place one foot isolated on the side of the deformity.

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• ICD 10 chalgus valgus.