Valgus deformation of the knee joints in children: treatment, causes

Valgus deformation of the knee joints – it is a misalignment of the knee inside, distortion of the shape of the feet and which gives them the appearance of the letters Kh the Disease is characterized by also tipping and internal rotation of the hip, and also a deviation from the tibia outwards.

Valgus of the knee - the most common pathology that affects mainly children and older people. Valgus deformation of the knee joints in children completely healed by conservative methods.

Characteristics of the disease

Lateral curvature of the lower extremities is characterized by the formation of the open outer angle between the thighs, because the inner condyles hips are developing faster outside. As a result the inner slit of the joint extends, and the outer - narrows. The process affects the ligamentous apparatus, which supports the joint. The ligaments are stretched from the inside, and when walking one is forced to widely arrange legs.

Morbid curvature of the legs, is considered in the case where the interval between the inner surfaces of the ankles fixed and firmly pressed together of the knees is more than 5 cm should be noted that in some newborns valgus curvature is the norm until they reach a certain age. A temporary defect explains lateroposition (deviation towards the outside) of the quadriceps and danger does not represent.

In extremely rare cases, a baby is born deformed, with his knees. If this happens, there is also the curvature of the femoral neck, valgus installation of the lower limbs and flat feet.

Children's valgus of the knee tends to be one-way and two-way. In the first case is deformed one limb, and for the other - both. A slight curvature in newborns is most commonly physiological norm, and as they mature the baby's legs straightened. However, the monitor process is necessary, in order not to miss the progression of the pathology.

If the deformation does not pass, it is necessary to take measures immediately, until the ligamentous apparatus and muscles of the child are at the stage of formation. The disease develops very rapidly from the moment a child begins to walk. The lower limbs are exposed to large loads, and muscle structure they can deal with it.

Valgus defect definitely need to treat, otherwise will suffer a musculoskeletal the musculoskeletal system.

Reasons

Deformation of the knee joints can cause the following conditions:

  • a high load on the legs is in a period of rapid growth when muscles and ligaments are poorly developed;
  • rickets, lack of vitamin D and calcium;
  • disease Erlacher-Blount (deforming osteochondrosis of the tibia);
  • paralysis of the limbs;
  • damaged pelvic bone;
  • overweight;
  • wearing uncomfortable shoes – too tight or, conversely, a wide;
  • injury and inflammation of the joints;
  • ecological factor.
valgus-knee -

The main and most common cause of foot deformities are congestion of the limbs, when the child begins to make the first steps. In the process of growth, shape and mutual position of the bones forming the knee joint, is changing. Quite small children to the right, just bend your legs at the knees, and while walking joints completely straighten. Instinctively the child puts legs wide, because the muscles are too weak. For this reason, varus (O-shaped) installation feet gradually, over several years, changes to the valgus. At the age of 5, 6 or 7 years everything will return to normal, and in the case that the remaining deformation is talking about the pathology.

Symptoms

Determine the valgus deformation of the knee both in children and in adults can be on the following attributes:

  • knees and feet are spread out, when it can develop flat feet;
  • during walking or standing arise fatigue and discomfort, but also feelings of pain;
  • when the loss of one knee perhaps, that the development of scoliosis;
  • due to the deformation of the foot change walking – it becomes a are not equal;
  • for congenital forms of valgus is the typical curvature of the femoral neck.

We distinguish 3 degrees of valgus deformation:

  • basic: deviation of the tibia towards the outside is not more than 15°;
  • second: tibia rejected by more than 15°;
  • third: for this stage is characteristic of the deviation of the lower limbs in the direction of greater than 20°.

Treatment

Treatment of valgus deformation of the knee joints in children complex and is named after the execution of diagnostic activities. To specify the severity of the disease they took x-rays. For the avoidance of joint disease, and evaluate indicators of biochemical analysis of blood: availability for C-reactive protein, rheumatoid factor and uric acid. With the help of the tests on the trace elements determine the level of calcium and phosphorus in the body.

Modern methods of therapy allow you to fully correct the shape of the foot and stop the further progression of the deformity. Uses several effective ways:

  • wearing orthopedic aids;
  • physiotherapy;
  • massage;
  • Movement therapy.
valgus-deformity-in-children

Orthopedic devices and physiotherapy

When the valgus deformation applies corrective stacking and tires, fixing the knee joint. Such products prescribed by a doctor-orthopedist, who in the course of the treatment process regulates the desired level of fixation. It should be borne in mind that the wearing of such objects can not be in violation of blood circulation in the lower extremities.

For strengthening and improving the contractile ability of the muscles of the lower leg prescribe such physiotherapeutic procedure, as electro-stimulation.

Through the action of the organism pulses of electric current were achieved the following results:

  • increases the volume and strength of muscles while maintaining the length of the muscle fibers;
  • increases adaptive capacity and limit fatigue of the muscle tissue;
  • reduces painful;
  • is to provide good drainage and rapid excretion of metabolites,
  • regenerates the nervous regulation of muscle contraction;
  • thanks to the alternating contraction and relaxation is alerted of muscle atrophy.

After the course of several procedures electrostimulation of the muscles will become stronger and it's easier for them to maintain the correct position of the feet when walking or standing. Before that, how to assign electrical stimulation, the doctor takes into account the following contraindications:

  • tendency to bleeding;
  • thrombophlebitis;
  • acute inflammatory and infectious processes in the body.

Massage

The stability of the joint ensures a muscular corset, so it is massaged several muscle groups – your back, buttocks, thighs and lower legs. A treatment course consists of 10-20 sessions, between courses are conducted two weeks either monthly breaks. The intensity of the impact of the increase after several procedures, the sharp and rough movements tolerated.

massage

Massage is done:

  • The patient lies down on his stomach, under the shins insert the roller.
  • Massaging the area of the lumbar, in a direction down and to the side from the spine. Then you need rubbing, kneading and pressure.
  • The sciatic department massage movements in a circle or in X-image direction, then vigorously pounded the outer surface of the bent fingers. Further, one or both hands to produce kneading. The final stage – the shock tricks: chipping operation, and also effleurage and pat.
  • Massage the back area of the thighs begins stroking in the direction from the knee up and out, then rubbing, kneading and effleurage movements of the fingers.
  • Tibia massage stroking in the direction from the heel up to the knee joint. Special attention is paid to the outer and inner sides of the lower extremities: the outer part of the massage gently, with minimal pressure, with the help of vibration, and the firm has increased strength techniques. At the end of the session - stroking. Massage the inner surface is performed intense, with the use of light attack techniques.
  • The knee joint is adjusted through the stroking and rubbing of the side faces, the pressure on the inner side of the joint in the patelofemorální condyle. At the time of the pressure of the free hand holds the lower leg at the bottom, trying to lead her as close as possible to the median line.
  • Achilles tendon strokes and massaging movements.
  • The patient turns on his back, the roller insert below the knee.
  • Massage the front part of the foot begin with the feet: movements, moving from the toes to the tibia massaging the back surface. Then followed by a vigorous rubbing and kneading of the inner part of the ankles and feet. When filling – stroking.
  • Circular motions to stroke the knee and down its lateral surface. Then produce a pressure on the inner side of the joint with the current brings the shin to the middle line.
  • The front surface of the lower limb massaging light friction movements in the direction from the bottom up.
  • Going to the hips, to stroking and medium-intensity rubbing and kneading. At the end – stroking the leg from the knee up and towards the outer side of the foot.

Therapeutic physical education

To correct the deformation, it is necessary long and stubborn work. To perform the exercise it is necessary regularly, at least 2 times a day, one approach should be after a massage.

Exercise 1. Flexion and extension of the ankle joints.

Exercise 2. The rotation of the feet alternately on the one and the other side. To carry out movements it is necessary gently and be careful to avoid painful feelings.

Exercise 3. Grasping and holding objects legs.

Exercise 4. The default position – posture in Turkish. From this provision it is necessary to get up, relying only on the outer part of the soles of the feet. If that doesn't work, you can ask someone, and perform the exercise with the support. Then sit down in the posture in Turkish and swap the legs so that the top was the second leg. Repeat the exercise again.

Exercise 5. Squat to poop, it is widely spread her knees to the sides. An important condition is the correct location of the stop: must fully stand on the floor and be parallel to each other.

Exercise 6. Rise on socks and stretch the whole body up. Then go down completely on his feet.

Exercise 7. Walking on the outer part of the soles of the feet.

Exercise 8. Walking along the narrow plank, a width of 10-15 see Instead of the plate can be oriented according to the painted variety or color strip on the carpet. The feet must be put as close as possible to each other.

photo-warping

Surgical treatment

In more advanced stages or with existing complications of valgus deformation of the correcting functional way. Typically, surgery is prescribed to older patients, as their disease often takes place in hard form. The indication of surgery is also used accompanying the deformation of the menisci of the knee joint, cured by conservative methods impossible.

Before the operation is performed a number of diagnostic activities with the use of magnetic resonance imaging and computer tomography.

The essence of the operation – the creation of artificial fractures with subsequent repair of the leg using the Ilizarov apparatus.

In the rehabilitation period of the operated limb under anesthesia, and walk use special products. Furthermore, patients are moving with the help of crutches. The device Ilizarov allows you to perform correction of the limbs and after surgery – a 8-e 9-e a day.

Operative treatment is applied also in the case of ineffectiveness of conservative methods. Then wedge the land of the tibia are removed surgically, and then the bone grows. In children under 16 years of deformed limbs immediately lead into the anatomically correct position.

To restore the function of the foot, prescribe a comprehensive therapeutic gymnastics. Exercise is necessary for building strong muscles that are able to keep your knees in the physiological position.

After surgery the patient is undergoing rehabilitation, which, in addition to medical gymnastics, includes physiotherapy and massage.

It is worth noting that early treatment gives the possibility to make optimistic forecasts even in the more advanced forms of valgus, and regardless of the age of the child. Making a medical recommendation, you can avoid such complications, such as gonarthrosis, damage to the meniscus and acl. Also excluded increased fatigue and injuries of the lower extremities, pain in the legs, as well as problems with the spine. To ensure the successful outcome of the treatment will help to wear orthopedic shoes, fixing the ankle joint.

15.08.2018