TREATMENT OF VALGUS FEET IN A CHILD

26 July 2018

Treatment of valgus feet in children in the age of 1 year and a little older leads to a favourable prognosis — the probability of full resolution of the problem approaches 100%.

Among the orthopedic diseases in children the change of foot is the most common pathology. Represents a curvature of the lower limb in the inner side. Develops under the influence of various external and internal factors. The shape of the foot: the shifted axis, the heel looks to the outside, the inner surface of the foot inward, deformed fingers. When tightly compressed knees distance between ankles is 4-5 cm

When detected late, in advanced cases of the disease in adolescence have a problem with the spine. The later treatment is started, the less likely a full recovery.

FACTORS AFFECTING THE DEVELOPMENT OF HALLUX VALGUS IN A CHILD

Deformation of foot in children is a congenital anomaly or acquired disease. In all cases, it is the wrong location of the stop relative to each other. Changes lead to the fact that the main load when walking, falls on the inner surface of the foot. The presence of symptoms in children up to 3 years says about the changes at the stage of pregnancy. The diagnosis is made by an orthopedic surgeon after a thorough examination.

The factors that are the impetus for the development of pathology include:

• the lack of food.
• a wrong diet;
• lack of vitamins and minerals in the body (a deficiency of calcium and/or vitamin D), leading to brittleness and softness of the bone tissue;
• early standing the child on his feet;
• mismatched shoes;
• often acute infections;
• the injured ankle;
• prolonged immobility of the lower limbs due to being in plaster.

If the child begins early to walk (up to 1 year) or it is forced parents, in many cases, the foot is deformed. At an early age is the formation of ligaments, which often are not ready to load.

THE CAUSES OF FORMATION OF HALLUX VALGUS FOOT

Congenital malformations of the musculoskeletal system of children — strain that develop during pregnancy in mom, and appear after birth. The degree of curvature in the case of congenital hallux valgus is very pronounced. This is due to a variety of defects of individual elements of the musculoskeletal system, abnormalities in genes or chromosomes. Breaking the bones of the foot and their shape in utero. Deformation of the stop is already apparent in the first months after the appearance of a baby into the world.

An example is the genetic disorder Edwards syndrome – abnormality of a particular chromosome, which is found heavy the degree of curvature of the foot is newborn stop rocking.

Other causes of congenital valgus foot, the child applies a number of pathologies, which are diagnosed in the first weeks of life:

• in 80% of cases connective tissue dysplasia with congenital hip injury;
• myodystrophy;
• cerebral palsy;
• polio and other infections of the Central nervous system;
• neuropathy – pathology of peripheral nerves.

The acquired form is the result of exposure to one or more factors after birth. Initially, the main reason is the weak apparatus of the foot, which is a violation of its correct position. This condition is diagnosed in the first days after birth. On the development of the pathology can be affected by:

• prematurity or born with small body mass;
• overweight in children;
• endocrine pathology (diabetes, hypothyroidism);
• of metabolic disorders (osteoporosis, disorders of lipid and carbohydrate metabolism).

VISIBLE SIGNS OF PATHOLOGY

Foot pain at the end of the day – the most common complaint of a child with the deformity. Objectively pathology manifests the following common characteristics:

• unstable gait when walking from side to side;
• education on the sole blisters;
• constantly divorced fingers;
• difficulties when you try to put your heels together.

Is determined by three types of disease:

1. Cross — extension of the forefoot with the expressed tension of muscles and tendons responsible for straightening the fingers. This causes the child pain.
2. Longitudinal — shows change of gait, the shape of the feet (if palpation there is severe pain), fatigue from a long stay on his feet because of the discomfort and pain.
3. Combo.

Develop mainly two types of deformity:

• X-shape (direct, tight knees the distance between the inner surfaces between the ankles is greater than 5 cm, feet as if looking outside);
• varus – O-shaped.

THE DEGREE OF DEVELOPMENT AND SEVERITY OF THE DISEASE

There are four stages of disease:

• I — a mild form of the disease characterized by a deformity of the foot no more than 15°, are well treated;
• Stage II — curvature up to 20°, is applied for therapeutic treatment;
• III degree — deformation up to 30°, require long intensive therapy;
• Stage IV — severe – deviation from the norm is more than 30°.

PATHOLOGY OF THE GREAT TOE

Deformity of the big toe, there may be pathology. The curvature of the first toe is dependent on the extent of pathology. The correction of the bone is carried out using:

• physio treatment;
• installation orthoses;
• the operating method.

THAN AND HOW TO TREAT?

Correction changes of the feet in children involves restoring the normal position of the joints, muscles and ligaments of the feet. The goal of treatment is the possibility of walking without pain and discomfort. Therapy must be comprehensive. For the treatment of valgus of the foot the child uses:

• conservative;
• operational;
• an alternative method (osteopathy – allows you to cure almost any, except for the genetically induced, pathology).

Conservative includes:

• medication;
• kinesiotherapy;
• orthotics;
• physiotherapy.

MEDICATION

Medical drugs in an X-shaped breach of the lower extremities are used to relieve inflammation and pain of the joints. The NSAIDs (non-steroidal anti-inflammatory drugs) or corticosteroids is assigned with symptomatic target. They are short-term, dangerous for children side effects.

NEW TECHNIQUES

Modern treatment is kinesiotherapy is an innovative method of treatment and prevention of diseases of the musculoskeletal system. It is based on the effects on the muscles by using a special tape – kinesiotherapy. The method name formed from two words: "kinesiot" means movement, "teip" – the actual tape. Is to apply a special tape of elastic material adhesive, does not cause allergies. Method teip developed several years ago a Japanese doctor Kenzo KASE for the treatment of sports injuries. In the future is widespread. Kinesiotherapy with hallux valgus in children is widely used in recent years. This is due to the safety methods: when using no restriction of movement, discomfort, not having allergies.

The fabric from which is made teip:

• it has a structure of fibers;
• good air permeability;
• does not absorb sweat;
• does not cause pain or discomfort;
• does not hinder movement;
• not afraid of water – you can swim without removing the tape.

The correct gluing teip speeds up the recovery of joints, ligaments and muscles without the use of drugs that can stop the progression of pathological changes. This safe method helps:

• the cessation of pain;
• to prevent further progression of the disease;
• a complete cure.

Rules kinesiotherapy:

• teip applies only to clean, dry skin;
• for prolonged use kinesiotype need the edges to make it round;
• after sticking teip ground, activating it.

MASSAGE ACTION

In the flat arch of the feet changes muscle tissue, leading to disruption of blood circulation, and in the future – to the development of irreversible processes. Therefore, massage is an indispensable part of the treatment. This is one of the physiotherapeutic methods of influence. Special skills for its implementation is not required, so you can make at home. The course is 10 sessions, if necessary, it is recommended to repeat every 3-4 months. The total time for one session is 20-30 minutes. We should start with a General massage – the child lying down on stomach with stretched along the body hands and turned sideways with his head. Movement and hand pressure must hurt.

Baby massage:

• back;
• the lumbar region;
• buttocks;
• the muscles and joints of the feet, feet.

Use the following methods:

• stroking;
• rubbing;
• kneading;
• Pat;
• blows the back of his hand;
• pinching;
• to shake.

The use of massage must:

• to eliminate the increased tone of the muscles of the foot and lower leg;
• to help get rid of unnecessary stress;
• strengthen the weak muscles, which contributes to the proper work of the whole muscular system;
• to improve blood flow to the muscles, ligaments, bones – it strengthens their power, and normalizes the growth and development of the lower extremities;
• to heal pathology in the early stages.

The baby in under 2 weeks this method eliminated the most serious health problems, including hip dysplasia. In this case, structural therapy is a specially developed technique of spot and vibration massage. With their help, redistributed the load on the joints. Feedback – improve blood circulation and disappearance of pain.

PHYSICAL therapy

The use of physical therapy in hallux valgus in children allows to correct disturbances in the joints and cure the disease in its early stages. Widely used:

• foot bath;
• wrap stop wax;
• electrophoresis of calcium;
• amplipulse therapy(effects on the body of the sinusoidal currents generated by the apparatus Amplipulse);
• wearing the right shoes;
• therapeutic swimming;
• physiotherapy;
• the magnetic therapy.

PLEASANT AND USEFUL GYMNASTICS

In the early stages of the deformity the child is treated with specific exercises. Their regular use helps to correct almost all the disorders in the joints. The elements of medical gymnastics you need to perform daily. The purpose of the physical therapy course individually, dependent on deformation. Included elements of the game that the child can carry items many times.

Daily need:

• to walk on toes and heels (first raised, and then compressed toes) for 5 minutes;
• to compress and decompress the toes sitting on the floor with the legs extended;
• to pick up small objects;
• walk barefoot on uneven surface (this can be done at home on the pebbles, ), on the outer edge of the foot;
• roll the foot roller or a small ball of wood;
• rotate the foot from left to right and Vice versa;
• squat without lifting feet on the floor.

Child needs:

• walking along a narrow path – it can be made at home from fabric or just draw;
• walk the curb on the street and in the summer, barefoot in the ground, sand, grass.

PROPER FOOTWEAR IN THE TREATMENT VERY IMPORTANT

Mismatched shoes over time can deform the foot and bend the big toe. Quality shoes contributes to the normal development of the muscles of the foot. When it is selected you need to consider:

• compliance with the foot size, convenience and comfort;
• manufacturer of natural materials;
• no sharp noses and heel in the Shoe for a teenager.

Proper shoes must have a closed rigid heel arch support. Not allowed prolonged wearing of sandals without heel fixed.

For the treatment of foot recommended special orthopedic appliances

• the insole;
• retainer;
• bandage;
• bus.

TO WALK OR NOT TO WALK BAREFOOT?

The best prevention of problems with feet — walking barefoot. This must be done not only on a level surface (floor), but also on rough terrain. If there is no opportunity for the child to run along the ground, grass and different bumps, the alternative is the Swedish wall, which parents can buy and mount in the nursery of the child. He works the muscles and the ligaments of the foot while climbing on it. Recommended for walking barefoot baby mats with convex elements, which can be bought in baby store or orthopedic salon.

WHEN SURGICAL TREATMENT IS REQUIRED?

The treatment of club-foot in children is held by a conservative. Radical intervention is used when there is no effect of the treatment of older children, where the basis of the musculoskeletal system is formed, there is no active growth of ligaments. Surgical correction consists of several stages of surgeries and long rehabilitation period, is held on the fourth stage of the disease when:

• intense pain in the foot constantly worried;
• develops rigidity (stiffness) of the joint.

Direct surgical intervention much. Therefore, the operation is scheduled based on the degree of disease of the foot, the presence of the deviation angle of the limb.

POSSIBLE CONSEQUENCES OF HALLUX VALGUS IN CHILDREN

Sore feet lead to a change in the entire musculoskeletal apparatus. This is due to the uneven load. Occurs:

• shortening or deformity of the feet;
• osteochondrosis;
• scoliosis at different spine.

The child:

• deteriorate gait;
• it becomes impossible for physical activity (Jogging, active games) due to pain and inflammation in the joints.