Hallux valgus deformity of the foot in children

She is accompanied by the following differences:

  • flattening of the longitudinal arch;
  • Hallux valgus position of the rear unit;
  • incorrect position of the front compartment.

The maximum percentage observed in children of younger school and preschool age. Although there are cases where this diagnosis may be considered as prohibited.

the deformation of the feet — copy

The shape of the foot, which developed in the course of evolution, provides uniform distribution of body weight. The bones of the feet, the united strength of the ligaments, consisting of the state, whose task is to provide maximum cushioning movements when running and walking. Bulging arches are oriented in two directions – transverse and longitudinal. Therefore, it is normal for the legs of an adult on three points of support – the head of the first dice, пяточный bump and the fifth bone.

In children, the flattening of the arch of the foot, usually occurs in the period when the child is just taking its first steps; it has to do with a fairly serious load on the foot when trying to make a move. Of course, you cannot expect from a toddler ideal for a correct determination of the stop or walk "from the hip" immediately after he first stood on his feet. No need to panic, or just put a cross in the athletic or military career.

As usual, the first parents ' complaints arise when a child makes his first independent steps. In this case, it is necessary to clearly distinguish between the physiological flattening of the arch of the foot of a child who has not yet reached the age of three years, and actually Hallux valgus deformity, which no longer requires the supervision of a doctor-orthopedist. To three years in children on the plantar aspect of the feet has a "fat pad", so when a simple visual examination of the arch is not visible. But it will be noticeable, if you ask your toddler to stand up on носочки. The bone tissue in a child continue to be up to 5-6 years, so it is just in this period it makes sense to start to talk about the absence or the presence of a child as such вальгусной DEFORMATION.

вальгусная deformation — copy

Although it should be borne in mind that Hallux valgus feet in children can lead to such adverse consequences, such as:

  • the strong curvature of the spine;
  • constant pain in the legs;
  • the "adults" of the disease – osteochondrosis, arthrosis.

In some cases, the diagnosis of "Hallux valgus feet", give the child still in the роддоме. In this case, instead of the congenital nature of the disease (vertical taran).

Causes deformation of the stop

  1. Dysplasia of the connective tissue (78%). Polluted water and air, foods of low quality lead to the fact that connective tissue, which is the basis of the apparatus of the joints (and also all other organs), it is formed correctly.
  2. Incorrect baby shoes (soft models with flat soles, it is not capable as it is necessary to fixate the leg).
  3. The child is not engaged in physical education in preschool institutions and in the family.
  4. Genetic and endocrine (diabetes, thyroid disease) disorders.
  5. Osteoporosis (the defeat of the bones of the skeleton).
  6. Various injuries of the foot.
Doctors there are a number of theories, using which it is possible to explain the different mechanisms:
  • анатомическая theory;
  • a mechanical theory;
  • the theory of hereditary muscle weakness;
  • theory конституциональной weakness of the connective tissue.
Classification:
  • correction in the treatment of feet;
  • congenital;
  • травматическая;
  • static.

Doctors there are three degrees of severity вальгусной deformation of the feet: light, medium and heavy. The so-called stop-rocking-chair (vertical ram, dog paperweights) – the most heavy degree of deformation. To draw attention to it right away at birth, the frequency of cases, identify - 1 on 10 000 newborn babies. Pathological this deformation has not been studied definitively. As the most likely cause of the deformation of the doctors there are defects in development and the delay of its development in one of the stages of the formation of the embryo.

The parameters of the feet in the standard:

  • if holding the two lines – in the lower perimeter of the heel bone and the first bone – so that the vertex of the angle was in the area of the bone in the form of ravens, this angle should be 125°;
  • the height of the longitudinal arch – 39-40 mm;
  • Hallux valgus the position of the rear flag foot – from 5 to 7°;
  • the angle of inclination of the calcaneus in relation to the plane of the bracket – from 20 to 25°.
diseases of the feet — copy

The height of the longitudinal arch of the feet in children of preschool age in the norm, may 19-24 mm.

Light level is characterized by the following parameters:

  • the height of the longitudinal arch of the foot is reduced to 15 to 20 mm;
  • the angle of the height of the arch is reduced to 140°;
  • the angle of inclination of the calcaneus – up to 15°;
  • my position of the rear separation – up to 10°;
  • abduction of the anterior department of the foot (8-10°).

High school degree:

  • vaults reduced to 10 mm;
  • the height of the vault is reduced to 150-160°;
  • the angle of inclination of the calcaneus up to 10°;
  • Hallux valgus position of the rear separation and the abduction of the front - to 15°.

Heavy grade:

  • vaults reduced to 0-5 mm;
  • the angle of the height of the arch of the foot decreased to 160-180°;
  • the angle of inclination of the calcaneus - 5-0°;
  • my position of the rear department and lead the front - more than 20°;
  • deformation when a heavy degree, and defies correction;
  • permanent painful in the area of Shoparov joint.

Feet – the foundation, the "foundation" of our body. And if this base curve, and a uniform, reliable, at home to build on it. Hallux valgus deformation of the feet carries with it a Hallux valgus (X-shaped) deformation of the knee and голеностопных joints, incorrect position of the pelvis, disorders of posture. The curvature of the axis of the spine and limbs leads to muscle overload, which will in vain try to hold the body in the correct position. As a result – the appearance of pain, the premature development of arthrosis, a degenerative disease of the disk.

Prevention

  1. Loading the legs of the toddler earlier than 7-8 months, it's not worth it. As elements of gymnastics приставлять toddler already possible before, but only in the short term and always with support.
  2. Spend the prevention of rickets.
  3. The child should wear the right shoes: have the fixed high back (higher heel 3-4 cm), which helps to hold the heel in the axis of the lower limbs, as well as the yoke bottom and a small супинатор.
  4. I'm sure it must undergo an examination by an orthopedist (1, 3 and 6 months of life, a year and three, 4 years – an annual visit).

Treatment

With regard to all of the above, parents need to remember that flat feet is a major problem only when the feet are not only flat, but also cause the anxiety of the child when walking or running. If when lifting the носочки the arch of the feet on the child look normal and does not in any way do not disturb, and treatment is not necessary.

If flat feet, are on the same painful, малоподвижными – it's a completely different situation. Here already need help, the orthopedic surgeon, regularly engaged in the legs, to competently assess the severity of the pathology and to develop the adequate tactics of conducting the patient. It can be as a prevention to help specialized shoes and operative treatment in different variations:

  • Operations Graisa (podtarannii artroerez).
  • Method Dobbsa for the treatment of vertical тарана (этапное the imposition of gypsum with subsequent push rays Киршнера).
treatment legs

Method Dobbsa is to do 5-6 sessions (one per week) щадящей manual correction of the deformation of the feet. Each session terminated by the introduction of gypsum involved the lower extremities, aiming to secure retention of the stop in the position of maximum correction. In this гипсовую bandage applied from the upper third of the thigh to the tips of her fingers with согнутым коленным суставом to 90°.

For 5-6 also clinical-рентгенологических session to normalize the anatomical relations in the joints of the middle and back of the flag foot. The last phase consists in the two surgical stripping: fixation of the joint using a needle Киршнера in the correct position ( under the control of ЭОП) and complete percutaneous surgery.

After these manipulations for a period of up to 8 weeks applied гипсовую bandage. After the spokes are removed, the child is in the shelter of the shoes (without fixation of the knee joint; with the card of the longitudinal arch; with the option of a full-fledged and a foothold on the legs). Then the highlight of recurrence of the deformation of the feet, up to 4-year-old children is associated with orthopedic mode of wearing breis. How and after treatment by the method of Ponseti, children wear breis in the first stage for 23 hours a day (up to 4 months), then the period of wear is gradually shrinking, and further breis to pull only at the time of sleep (day and night). Unlike methods Ponseti is only in the angular configuration of the surfaces of the foot. Furthermore, children, вылеченные by the method of Dobbs, wear ортопедическую shoes with the performance of the longitudinal arch.

stop

It must be remembered, that, in determining the diagnosis and treatment of all the nuances is necessary to coordinate both with the orthopedist, as well as with doctors of related fields (therapist, doctor of physical therapy, physical therapist, etc.).

07.08.2018