hallux valgus deformation of foot in children - causes, symptoms, diagnosis and treatment

hallux valgus deformation of foot in children – a defect of the foot characterized by a decrease in the height of its arches and X-shaped curvature of the axis. When hallux valgus in children marked a reversal of the fingers and the heel outward, the omission of the middle part of the foot, clumsiness of gait, fatigue and pain in the legs. Diagnosis of hallux valgus in children is a children's orthopedist on the basis of visual inspection, radiography stop in 3 projections, de plantography, submetry. Treatment of hallux valgus in children is performed using physical therapy, massage, wearing orthopedic shoes, orthopedic blend of tires; the ineffectiveness is performed surgery.

hallux valgus in children

Under valgus deformity refers to a foot deformity in children in which, when stricta compression and straightening of the knees, the distance between the inner edges of the ankles is more than 4-5 cm in the toes and heel are deflected to the outer side and the inner arches "collapse" inward. This curvature of the legs is called X-shaped, unlike varus (O-shaped) deformation feet. If hallux valgus deformity accompanied by a decrease in the height of the arches of the foot, talking about flat-valgus foot deformities in children. This form of disease is most often found in children's traumatology and orthopedics.

Causes of hallux valgus in children

hallux valgus foot deformity, the child may be congenital or acquired. In the first case the determining factor is intrauterine disorders shape and arrangement of the bones of the foot, and talipes are diagnosed in the first months of a child's life. True to the most severe congenital foot deformity is "stop rocking" or "vertical battering RAM."

Acquired hallux valgus deformation of foot in children is associated with the imperfection of the tendinous-ligamentous apparatus and developmental disabilities of the musculoskeletal system of the child. Such deviations are usually detected by 10-12 months, when the child's attempts to make the first steps. hallux valgus deformity of the foot often formed in immunocompromised children with hypotonia. The reasons for the last can lie in prematurities child, fetal malnutrition, congenital weakness of the connective tissue, a frequent disease in young children respiratory catarrh, bronchitis ,pneumonias. A special role in the weakening of the ligament-muscular and skeletal apparatus of the foot belongs to rickets. Violation of the static-dynamic relationship in the lower extremities secondary develops in children on the background of neuromuscular diseases: polyneuropathy, cerebral palsy, myodystrophies,polio. hallux valgus deformation of foot in children can be due to obesity and excessive stress on the foot due to excess body weight.

Sometimes hallux valgus deformation of foot in children develops after injuries of ligaments, muscles, bones of the leg and foot and long stay limbs in plaster. In more rare cases, hallux valgus deformity occurs in children with dysplasia and congenital hip peccetur. Causes of hallux valgus in children there may be the early formulation of the child on its feet, ill-fitting shoes (too soft and bad locking foot).

The weakness in the muscle tone under the weight of the child, the arch of the foot is flattened, tibial muscles, and the muscles and ligaments of the toes stretched and weakened and can't hold the foot in the optimal position. When hallux valgus in children is offset from the ankle joint inwards, and the heel and fingers outwards.

The symptoms of hallux valgus in children

In most cases, the first signs of hallux valgus in children parents find closer to 1 year, shortly after the child took the first steps. While paying attention to that when walking the baby does not occur on the whole foot, and on its inner edge.

Over time the foot becomes X-shaped, the gait is clumsy, insecure, the children get tired quickly when playing with peers, complain of pain in the lower extremities and spine. By the evening the foot of a child swelling, cramping in the calf muscles. When inspecting the shoes of a child significantly its uneven gerunt - shoes noster on the inner side of the sole.

hallux valgus foot deformity in children can lead to development of a platypodia, limb shortening,scoliosis, degenerative disc disease, deformities of the pelvis, knee and ankle joints of the feet, osteoarthritis.

Diagnosis of hallux valgus in children

hallux valgus foot deformity, the child may be seen by the pediatrician, but finally, to judge the presence of pathology and its severity allows only the inspection of children's traumatologist-orthopedist and special examination. During the child's examination draws attention to the deflection of the fingers and the heel outwards, smoothing the arches and the offset of the inner part of the foot – inside.

For the final solution of the diagnosis of hallux valgus in children is radiography of the feet, computer plantography and podometry. On radiographs of the feet, performed in 3 projections, it is possible to observe the change of the position of the stop relative to each other. Computer plantography allows you to calculate different morphological parameters of the foot. Using submetry estimated load distribution on different parts of the foot. Computer podometry allows to detect changes when clinical signs of hallux valgus in children has not yet emerged. In some cases, to clarify the diagnosis may require ultrasound of the joints.

To exclude pathologies of the Central and peripheral nervous system children with valgus deformity of the foot must be examined by a child neurologist.

Treatment of hallux valgus in children

hallux valgus in children treatment

The goal of treatment of hallux valgus in children is the restoration of normal form and function, strengthening of the muscular and ligamentous apparatus.

In congenital hallux valgus in children may require immobilization of the limb using plaster bandages. Selection and modeling of the bandage is a children's orthopedist regarding the type of deformation and the degree of deviation from the norm.

In the next step (and in the case of acquired hallux valgus in children from the beginning) recommended a foot bath massage courses ( lumborum-sacralis region, joints, legs, feet), paraffin, ozokerite and mud applications,electrophoresis, diadynamics, magnetotherapy, electrostimulation of the muscles of the leg and foot, IRT. Useful classes of therapeutic swimming and exercise therapy.

Children with valgus deformity of the foot require the selection of individual functional inserts or special orthopedic shoes with a rigid lateral fixation of the foot and heel arch support.

For surgical treatment of hallux valgus in children is resorted to relatively infrequently (about 7% of cases). A method of correcting hallux valgus feet in children is determined by individual characteristics and severity of disease. Most common in children's traumatology, orthopedics received methods of transplantation of the tendon of the long peroneal muscles on the inner edge of the foot with Achilles tendon lengthening; arthrodesis talus de-have joint, the imposition of external fixation device, etc.

Forecast and prevention of hallux valgus in children

hallux valgus deformation of foot in children can reach severe degrees, being not only a pronounced cosmetic defect, but also causing functional impairment of the limb, until the disability in the young working age. In the case of a low degree of deformation and timely treatment possible full recovery of function of the foot.

To avoid the development of hallux valgus in children should avoid strain on the lower limbs of the child until 7-8 months. You must adopt a rational mode that includes hardening, gymnastics, preventive massage, good nutrition, adequate sleep and walks. The importance of the prevention of rickets, vitamin D and trace elements.

It is obligatory to regularly visit the pediatrician and preventive examinations carried out by experts in different fields (including pediatric surgeon and prosthodontist). You need to pay attention to proper selection of shoes for a child: it must be the same size (not small and not large); made of quality natural materials; have a solid arch support, rigid rear and side.

04.08.2018