Flat valgus foot in a child

This treatment is indicated in courses, the duration of which is determined individually and depends on the severity of the deformity.

Flat feet in children. Can you let it grow out?

How does the shape of the lower limbs change naturally in children?

A child who is beginning to walk will have varus position and leg flexion because he is not yet able to fully straighten his hips and knees. His steps are tentative, his feet are wide apart and the foot rests on the entire sole (the typical rolling from heel to toe is missing). The sole of the foot is covered by a pad of fat that acts as a shock absorber and protects the cartilaginous structure of the foot from excessive stress during quick steps. The fat pad disappears between the ages of 4 and 5 - at which point the foot may appear visually flat.
By the age of 2 years, the valgus knee disappears - the lower limbs become straight. Physiological valgus occurs at the age of 3 years and resolves by the age of 8 years. At this age, parents usually worry about the shape of their child's feet and often consult an orthopedist.

Where does preschool valgus in the feet and knees come from?

The changes in the axial position of the lower limbs are due to the upright posture of the body and the forces acting on the articular cartilage of the femur and tibia. In 3-year-old children, the greatest functional internal rotation occurs at the hip joints - at this age, children often walk their legs inwards. Internal rotation of the lower limbs is the result of a naturally increased angle of rotation of the femoral neck of 30-35 degrees (the norm for adults is 12 degrees) and an increased antegrade (tilting) inclination of the acetabulum. Internal rotation of the lower limbs results in tilting of the medial tibial joint and increased stress on the medial arch of the foot. Flat feet at the age of 3-4 years are a natural compensation for the increased rotation angle of the femoral neck.

The recipe is very simple: keep your child as active as possible. Instead of driving your child in the car or stroller most of the time, give him the opportunity to go for a walk. By actively rotating the pelvis around the longitudinal axis of the supporting leg while walking, you can reposition the femoral neck and gradually reduce the angle of rotation. A straight trunk when walking and spontaneous activity help maintain the correct balance of muscle tone between the flexors and extensors and the adductors and adductors of the hip joint. Prolonged forced sitting in one position limits hip mobility and makes it difficult to change the torsional deformation of the femoral neck and 'outgrow' the physiological valgus. If the child runs little and is carried most of the time, the medial gluteal muscles are not sufficiently strengthened. The child's weight increases, but the muscles cannot keep up with the changes, resulting in a reduced ability to actively stabilize the body. Walking is also the best workout for the foot muscles, especially the muscles responsible for forming the arch of the foot.
Spontaneous, unrestricted activity and walking, which allows for muscle training, body weight loading and pelvic rotational movements, are therefore essential for a child to grow out of a physiological valgus deformity. In addition, children's shoes should allow free movement of the toes (the sole should be flexible at toe level). The best choice is sports shoes or sneakers.

Characteristics of the disease

A child with valgus changes his gait in an abnormal way to stabilize his body position in space. E. O. Komarovsky warns parents that this leads to a serious illness that is difficult to treat conservatively:

• osteochondrosis of the lumbosacral spine;
• deformities of the hip, knee and ankle joints;
• Osteoarthritis of the foot with irreversible destruction of hyaline cartilage.

These complications take years to develop and are diagnosed less and less often. In modern pediatrics, regular examination of patients is practiced. The difficulty lies in the different etiology of the valgus deformity. What the pathology can be:

A congenital deformity is usually diagnosed before the age of six months and treated immediately by pediatric orthopedists. Early detection of acquired anomalies often depends on the vigilance of mothers and fathers. Abnormal foot formation becomes noticeable at 11 months of age, when the child begins to move with relative confidence. Dr. Komarovsky warns that flat foot deformity is detected in a child with insufficient muscle tone. Skeletal muscle abnormalities occur for the following reasons:

• prematurity;
• abnormal collagen biosynthesis, which results in hypermobility of the joints and increased elasticity of the ligaments and tendons;
• Rickets, a disease characterized by impaired bone formation and inadequate bone mineralization;
• Low resistance to viral and bacterial infectious agents and frequent inflammation of the bronchi, tonsils, larynx and bronchioles.

Valgus deformity occurs when a pathology is detected in a child in which the static and dynamic relationships are partially or completely disrupted. This disorder is associated with cerebral palsy, polyneuropathy, myodystrophy and poliomyelitis. Abnormal toe and heel rotation may be the result of long-term immobilization of the child following a fracture, sprain, ligament or tendon rupture.

Dr. Komarovsky on the valgus foot deformity

The renowned pediatrician warns parents that they sometimes provoke the development of the pathology themselves. This is especially true for obese infants. Your musculoskeletal system is just beginning to form, and the ligaments and tendons are too flexible, the muscular corset of the foot is not strong enough. When an obese child begins to walk, the soles of his feet are put under strain, resulting in a valgus-like deformity. The same negative scenario occurs when mothers and fathers forestall the natural course of things. You put the child on its feet too early and force it to take its first steps. The elastic bands are not yet able to support the baby's weight, so they begin to stretch and destabilize the leg joints.

Dr. Komarovsky often talks with parents, drawing their attention to the causes of pathology, timely detection and methods of conservative treatment. Here are his recommendations:

• When choosing footwear for children, you should not go too far - immediately buy orthopedic shoes that put a lot of strain on the foot, or give preference to wide sandals with a flat sole. The best choice is a shoe with a small heel that fits well but doesn't restrict movement. Sandals and shoes can be one of the criteria for diagnosing valgus deformity. The greatest wear occurs on the inside of the shoes;
• To prevent rickets in the cold season, when the sun is hidden behind clouds, pediatricians prescribe an oil solution containing ergocalciferol to newborns and older children. The fat-soluble vitamin D promotes the optimal absorption (assimilation) of the trace element calcium. The doctor's recommendation should not be taken lightly, because taking ergocalciferol helps the bones, cartilage, supporting ligaments and tendons of the foot form properly;
• If parents suspect that their child's feet are not developing properly, they can contact a pediatrician directly. The pediatrician has all the necessary skills to diagnose a valgus deformity. A pediatric orthopedist will be involved in further treatment. If necessary, other specialists such as endocrinologists, neurologists or immunologists are also involved in the treatment;
• Early treatment offers a 100 percent chance of avoiding serious complications. Dr. However, Komarovsky advises parents not to panic if their child is scheduled for surgery. The operations are carried out by experienced orthopedic surgeons who regularly confirm their qualifications.

Flat valgus foot in children

It is not uncommon for newborns to develop, among other things, clubfoot. clubfootAssociated with intramedullary mechanical impaction. The foot is of normal size and the deformity is moderate and can be corrected by passive manipulation. If the deformity is severe, parents must be taught passive exercises to correct it.

Clubfoot equinovarus – A complex deformity in which the entire foot is inverted and supinated and the forefoot is adducted. The heel is turned inwards and is in a plantar flexed position. The affected foot is shortened and the lower leg muscles are thinned.

position Foot is fixed and cannot be completely corrected. In many cases both feet are affected. The incidence of equinovarus deformity is 0.9 per 1,000 live births and is more common in males (male to female ratio 2:1).

There is an inheritance predisposition to this disease (polygenic inheritance), it can also develop secondary to malformations in pregnancy and as a manifestation of multiple malformations or neuromuscular diseases (including spina bifida). There is a connection with hip dysplasia.

The treatment should be initiated immediately (while the tissue of the foot is still malleable) and includes redression (gradual stretching and compression of the tissue) or gradual casting. If these measures are sufficiently effective, treatment can be discontinued or limited to overnight splinting. Severe deformities often require corrective treatment.

Hypertrophic foot in children

split foot Is characterized by increased curvature of the arch of the foot. In older children it usually occurs in connection with neuromuscular diseases such as Friedreich's ataxia or hereditary motor-sensory neuropathy type I.

In the presence of pain or other symptoms Treatment may be required.

Equinovarus foot deformity in children:
– A differential diagnosis of clubfoot is required.
– Neuromuscular diseases, spinal lesions and hip dysplasia should be ruled out.

Publisher: Iskander Milewski. Release update date: 3/18/2021

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Prevention of leg deformities in children

To prevent the development of curvature of the lower limbs, it is worth following the following advice from experts:

1. Choose the right orthopedic shoes that your child can wear comfortably;
2. Treat various diseases in a timely manner;
3. Visit the orthopedist regularly;
4. Strengthen your child's body;
5. Give your child a general massage course early on;
6. Regularly perform special gymnastic exercises;
7. Provide your child with a nutritious diet rich in vitamins and minerals.

Remember!!! While your child is still young, deformities such as varus and valgus of the lower limbs can be corrected if something is done about it in a timely manner. While your child's body is still malleable, it is important that you provide your child with the following Foot massage for children for his happy and healthy future.

TREATMENT OF VALGUS FOOT DEFORMITY IN CHILDREN

As already mentioned, the treatment of valgus foot deformity should be comprehensive.

Osteopathic techniques are one of the most modern and effective methods for treating valgus deformities in children of all ages.

Osteopathy works by looking at the body as a whole and using its techniques to identify and treat the root cause. Regular visits to the osteopath correct not only the arch of the foot, but also posture and gait, while specific techniques act on the immune system, strengthening it and making the body more resistant to various infections. In addition, in osteopathy there are a number of techniques, the use of which leads to the normalization of metabolism, including mineral and electrolyte metabolism, and the restoration of hormonal balance. It is this effect and approach that ensures that valgus deformities, regardless of the causes mentioned above, can be successfully treated with osteopathy.

Dear parents, if you have any questions, we are happy to help you! You can ask us your questions in the form below and we will answer them for you!

diagnostic methods

Diagnosis and treatment of valgus foot deformity is carried out by a doctor, orthopedist or traumatologist. The visit may be initiated by the child's parents or by a pediatrician who detects symptoms of leg curvature during a subsequent visit. At the first consultation, the doctor examines the child's feet and assesses the degree of deviation of the first toe and heel in different positions. He also checks the condition of the transverse and longitudinal arch and determines whether there is an abnormal alignment of the foot to the internal axis.

In addition to visual examination, the following methods are helpful in diagnosing valgus in children:

• Taking anamnesis. The doctor asks about the symptoms that are troubling the child. Talk about the symptoms, how long they have been occurring, and what activities cause them to increase or decrease. The orthopedist can ask about the child's illnesses, close relatives, lifestyle and relationship to sports.
• X-rays of the foot in 3 projections. Using the x-ray images, we can determine with high accuracy the degree of foot valgus in relation to the axis to determine the degree and stage of VFD.
• Plantography is a method of examining the condition of the arches of the feet using footprints.
• Other instrumental examinations (ultrasound, CT, MRI) to assess the condition of the joints and vessels of the foot.

Since valgus can be caused by chronic or congenital diseases, it may be necessary to consult other specialists such as a rheumatologist, endocrinologist or neurologist.

Treatment of valgus

Valgus deformities in children can be treated conservatively or surgically. Conservative treatment is effective in the early stages of the disease. It consists of:

• The use of orthopedic devices to evenly distribute the load on the foot and correct its position when walking. The orthopedic surgeon equips the child with special insoles, bands and toe supports.
• Choosing footwear. They must be comfortable and have a low heel (up to 3-4 cm).
• Therapeutic exercises to strengthen the ligaments of the feet. The doctor selects a series of exercises and gives recommendations on how to perform them.
• Foot massages, foot baths and physiotherapeutic treatments can complement conservative therapy. If the joint is painful and inflamed, the doctor may prescribe nonsteroidal anti-inflammatory drugs.

If the foot deformity is severe and conservative treatment is ineffective, surgical treatment is indicated. In 80-85 % cases, surgical intervention can permanently eliminate the external symptoms of valgus and relieve the patient of foot pain. Other treatment methods cannot permanently cure VDS. However, they help stop the progression of the disease and reduce the risk of complications.

How do you apply for benefits for free orthopedic shoes for your child?

First, let's clarify the question: How to choose the right shoes for a toddler?
If your child is under one year old but there is already a suspicion of foot curvature, choose shoes that are as light and comfortable as possible. This means they should have minimal seams but fit securely.
Remember!!!
The main task of parents with a child under 1 year old is to make wearing shoes a habit.
When your child is about 3 years old, the shoes should have a firm back and a deep sole. They should have laces or velcro to keep the ankle tight.
When choosing shoes for children aged 3 to 7 years, you should pay attention to the fact that the shoe has a rigid heel counter and a firm insole, which, however, does not put pressure on the toes and gently hugs the wide part of the foot.
For a child with a flat valgus deformity, the use of orthopedic insoles, which are custom-made and changed as the child grows, is mandatory.
The sewing of special orthopedic shoes in Ukraine is regulated at the state level.

You may be interested to know that a state orthopedic social program for children up to 18 years of age and special categories has been developed and is being implemented in major cities.
If a child is diagnosed with valgus foot deformity, parents can order custom-made special orthopedic shoes free of charge. The following requirements are required:

1. Apply for a transfer at the local office for labor and social affairs
2. Fill out the application form, provide copies of the birth certificate, TIN, LCC certificate, registration certificate of place of residence and certificate of benefits
3. Choose a manufacturer from the catalog of rehabilitation products
4. Visit the company yourself with the documents

Prevention of foot deformities should begin at a young age:

• Walking barefoot on uneven surfaces (pebbles, grass, sand). Alternatively, you can use special massage mats;
• games and exercises with massage balls;
• Anatomical shoes with a solid back and a closed, wide forefoot with a small heel (up to 0.5 cm);
• Prophylactic insoles from the age of 5-7 years.

However, there are also anomalies. The most common problem is flat feet. The child supports himself on the inside edge of the foot and the heel comes out'. Over time, an X-shaped curvature of the foot develops.

Causes of valgus feet in children:

• overweight, obesity;
• prematurity;
• Early onset (up to 10 months);
• inherited predisposition;
• Diseases (rickets, cerebral palsy, polio, frequent acute respiratory infections, etc.).
• sedentary lifestyle;
• Walking only on flat surfaces (tiles, parquet, laminate, linoleum, etc.);
• unsuitable footwear.

In the initial stages of the disease, the child may not feel any discomfort. In the advanced stage of the disease, the child simply feels uncomfortable when walking and talks about foot pain. The foot deformity can be easily recognized by the changed shape of the shoes that the child wears, and then only visually.

The disease is difficult to recognize: at first it is not noticeable. However, if it remains untreated, the deformity will continue to develop and lead to serious consequences: poor posture, pain in the knee and hip joints, and increasing fatigue. It will be difficult for the child to lead a healthy lifestyle and play and play sports with peers.

The first signs of an abnormality can be seen in the shape of the child's shoes, which are more worn on the inside of the shoe.

Treatment

Treatment of childhood valgus consists of restoring the correct shape of the foot and strengthening the muscles and ligaments. Valgus foot in a newborn caused by a congenital defect requires immobilization. The modeling and selection of bandages is carried out by an orthopedist, taking into account the degree of deviation and the type of deformity.

In the acquired form, massages, baths, electrophoresis, paraffin therapy, physiotherapy and swimming are indicated. In rare cases, surgical treatment is performed. Treatment of valgus in children is limited to the purchase of special orthopedic shoes.

Example
The parents of a one-year-old girl noticed that their child was walking on the outside in and upon self-examination discovered that the feet were turned inward. They consulted an orthopedist friend and it turned out that the girl had valgus feet. The doctor recommended purchasing special shoes for valgus feet - high and stiff in the back, with a special heel shape, with a mandatory roller on the insole. A massage treatment is indicated, as is constant wearing of orthopedic shoes at home and outdoors. The prognosis is favorable. Within a few years, the patient reported positive dynamics - the pathology completely disappeared if the parents followed all the doctor's recommendations.

Expert conclusions

A valgus foot in a child is most often diagnosed by an orthopedist during a routine visit. In the vast majority of cases, the pathology is corrected through massage, physiotherapy, wearing special shoes and physiotherapy. Complications are not common, but they include flat feet, disability, poor posture, and joint problems. The diagnosis is made on the basis of a visual examination of the child, x-rays and ultrasound scans.

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Experienced pediatrician with extensive experience and clinical work in various medical institutions in the areas of general pediatrics, intensive care medicine, anesthesiology and neuroinfection. Works with leading specialists, participates in international and Russian conferences.

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