Treatment for flat-valgus foot in a child

The flat-valgus foot is the most common pediatric orthopedic pathology. They usually encounter it in the first years of a child's life, because it becomes obvious after the baby begins to master independent walking. What to do if such a curvature is detected, we will tell you in this article.

What it is

In fact, hallux valgus and flat feet are different pathologies of the lower extremities, but in children it is most often the combination of a decrease in the arch of the feet, characteristic of flat feet, and a change in the position of the foot under load with inward displacement, characteristic of hallux valgus, is observed.

Hallux valgus is a deformity in which the child is in an upright position rests mainly on the inside of the feet, and the toes and heel are deployed outward.

Normally, the setting of the legs should be parallel, that is, when looking at two standing legs from behind, you can mentally draw two straight vertical lines. In a child with hallux valgus, these lines are refracted in the area of the ankle joint with a deviation to the outside, which determines the second name of the pathology - X-shaped deformation.

With flat feet, everything is much more complicated. All children have a physiological flat foot from birth, so it cannot be considered a pathology at 1-2 years old. However, orthopedists consider the problem in a comprehensive manner, and in the child's medical record a frightening diagnosis for the parents appears - planovalgus deformity.

Causes

Rarely enough, valgus curvature can be congenital. For some reason, the lower limbs of the fetus in the womb begin to develop abnormally. Such legs are visible almost immediately after the baby is born, and at 2-3 months the diagnosis is usually made quite reasonably.

More often, the pathology has an acquired character. Flat-valgus feet can become due to the excessive load on the baby's weak legs. This happens if parents start putting their baby in a walker or jumper too early.

Verticalization devices cannot be used up to 9 months.

Tendons and muscles of the legs in babies are weak, in addition, some children have a congenital feature - weakness of the connective tissue, which is why any negative impact associated with a large load on the legs can lead to hallux valgus, which, due to age characteristics, makes a duet with physiological flat feet in young children, and pathological flat feet in older children.

Most susceptible to the disease:

premature and low birth weight children;
children with cerebral palsy and other neuromuscular pathologies;
overweight chubby children;
children with hip dysplasia;
babies who have had rickets;
weak and often sick toddlers;
children who wear uncomfortable and too soft shoes that do not support the foot;
children who have suffered injuries to the ankle, knee joint, muscles or tendons, metatarsal bones of the foot.

Symptoms

The flat-valgus foot in the early stages at an early age is quite difficult to distinguish for the non-professional parental eye. All babies are clumsy, making their first steps, they all shuffle a little, and in most cases this is the most common thing. However, an orthopedic specialist can determine the incipient deformity at a very early stage.

In children after one and a half years and older, improper positioning of the foot is accompanied by symptoms such as fatigue, pain in the legs when walking, inability to run fast, swelling of the lower extremities in the evenings after a day spent in an upright position.

When the Latin letter X in the outlines of two legs set side by side begins to be obvious, we are usually talking about a serious degree of anomaly.

A flat-valgus foot is not a sentence. With timely initiation of treatment, with a responsible and systematic approach to it by the parents, the functions of the foot in case of mild pathology can be restored in full. It all depends on the degree of the disease.

The degrees themselves are measured by the angle of deviation of the vertical axis from the norm and the height of the arch of the foot. The larger the deflection angle and the lower the height, the more severe the pathology is considered.

Surgical intervention may require 3-4 degrees of planovalgus deformity. Lighter foot placement disorders are corrected conservatively.

Conservative treatment

The treatment will certainly be comprehensive. Individual activities and procedures will not bring the desired result. Also, parents should be mentally prepared for the fact that the process of getting rid of the deformation will take a long time. The higher the degree of the disease, the longer it will take for treatment.

Sometimes the therapy takes years. In fact, the child's lifestyle should change, all the prescriptions of the orthopedic surgeon should become an integral part of it.

Orthopedic shoes

The wearing of special shoes, aimed at the forced correct positioning of the foot, may be required for children with 2-3 degrees of pathology, as well as for babies who have undergone surgery on their feet with 3-4 degrees of deformation.

You should not try to find such a pair of shoes yourself. The therapeutic couple is the task of professionals. First, the orthopedic surgeon will give a reasoned conclusion and description, in which he will indicate the parameters of the anomaly, the degrees of deviation in the position of the foot, and will also give quite definite parameters of the height of the arch of the foot of a particular patient.

With these recommendations, parents will have to go to an orthopedic salon, where they will find the necessary pair, and if the necessary shoes are not on sale, they will sew them for the baby to order.

Orthopedic shoes with a flat-valgus setting of the legs should have high and firm backs, dense sides, so that the leg is securely fixed in the correct position. These shoes have instep supports and special orthopedic insoles.

A real orthopedic shoe pair is expensive, and this is what often becomes the reason for refusal to purchase. Parents are trying to find a cheaper alternative on their own. Experience shows that this is impossible, since not a single manufacturer of ordinary children's shoes, even if they position their product as orthopedic, makes steam for a crooked foot.

Even the best sandals from a good manufacturer are designed for a normal foot position; they are not designed to correct a crooked foot.

That is why it is important to find funds and purchase real orthopedic shoes, which, together with other methods of treatment, will definitely give a positive result.

Massage

Massage is a prerequisite for a successful recovery. You can, of course, do it with a professional massage therapist, but given that there will be many courses, it is better to save the family budget (massage is an expensive pleasure) and learn how to do it yourself.

The massage is based on classical techniques that are based on stroking, kneading and vibration.

The order of techniques on each massage zone is exactly the same: at first, lightly stroke, massage more deeply, tap and finish the session with light soothing strokes.

Massage with planovalgus deformity is necessary:

feet, toes, metatarsal areas of the foot, heel;
ankle with circular movements around the ankle joint;
knee joint in a circular motion;
the front and back of the thigh;
buttocks;
lumbosacral region;
lower back.

You can complete the massage with a foot bath, in which the warm water will gradually turn cold, parents should add cold water at a slow pace. Vigorous rubbing of feet, shins and thighs with a hard towel is helpful.

Usually a massage course is prescribed for 10-14 days, then after a 2-3-week break the course is repeated. Massage improves blood circulation in the lower extremities, strengthens ligaments and muscles.

Foot bath

And with a mild form of the disease, and with a deformity of 2-3-4 degrees, it is useful to give the child evening relaxing baths with a therapeutic effect. They use warm water with added decoction of medicinal plants.

Usually, a decoction of chamomile (for 250 ml of water - 1 teaspoon of dry herbal collection) helps to calm the legs, improve blood circulation, relieve puffiness and tension. You can also use burdock root with a teaspoon of regular baking soda added to the solution ready for the bath.

Paraffin therapy

This is a method of alternative therapy, which in no way replaces the classic in this case massage, gymnastics, physiotherapy and wearing orthopedic shoes. However, this method has established itself as an effective adjunctive treatment.

The essence of paraffin therapy is in the imposition of a heat compress on the sore spot from a special purified paraffinpreheated, plastic and elastic.

In the case of flat-valgus staging, the procedure is called “paraffin boots”. "Boots" are formed from medical paraffin by applying it to the feet and ankles, which are wrapped in polyethylene on top. A warm compress is kept on the legs for about 15-20 minutes. This allows the muscles and ligaments to be warmed up and blood circulation improved.

The procedures can be carried out in courses, as well as massage. To do this, it is also not necessary to sign up for a paraffin therapy session at a medical center or clinic, paraffin is sold in pharmacies, and its use at home will not cause any difficulties.

Gymnastics

The gymnastic complex for this pathology includes more than 20 exercises aimed at strengthening the muscles and ligaments of the lower extremities. A specialist instructor will be able to train parents and a child in therapeutic gymnastics in the exercise therapy office in the clinic at the place of residence.

The exercises are simple, accessible to everyone, they should be performed daily, at home. You can include in the complex a block of exercises in a standing position on a special massage mat. For these purposes, you can choose an orthopedic applicator mat, made of hard materials and having a sufficiently high hard relief or based on massage needles.

An orthopedic surgeon will also help you choose the right mat.

Physiotherapy

In the treatment of flat-valgus installation of the foot, the possibilities of electrophoresis, magnetotherapy, and electrical muscle stimulation are used. It is not possible to carry out all these procedures at home, you will have to visit a polyclinic or a private medical center.

Physiotherapy itself in this case does not cure anything, but it strengthens and complements the effect that, in aggregate, give the other components of complex therapy

Lifestyle

Parents of plump kids with extra pounds will have to put the child on a diet, since weight affects the rate of deformation. The higher the weight, the faster the degenerative processes in the joints, ligaments and muscle tissue develop.

A pediatrician and a nutritionist come to the rescue, a special menu rich in calcium, magnesium, vitamins B, C, E, D, PP is signed for the child. All fast food, smoked meats, pickled and spicy foods are excluded from the child's diet.

Fatty meat is replaced with dietary meat, canned food - for boiled and baked fish, fish cakes. There should always be fruits and fresh vegetables on the child's table.

If the baby has led a sedentary lifestyle, the whole family is advised to get up from behind computers and take quiet walks more often, a baby with a flat-valgus foot should not play football and hockey, skate, but swimming and cycling will be beneficial.

The loads on the legs should be increased gradually as the positive dynamics in the treatment process. You will regularly have to visit an orthopedist to monitor the situation from a professional point of view.

Operative treatment

Surgically, the problem is solved only if conservative treatment did not bring a result, if instead of improvement the child showed deterioration, as well as with 3-4 degrees of pathology outside of conservative treatment.

There are several methods that surgeons can use to manipulate the foot. This is the strengthening of the tendons, and the plastic of the metatarsal bones. The most effective is arthroereisis of the subtalar joint.

A small cylinder-implant is inserted between the talus and heel bones, which wedges the bones and brings the foot into the correct position. During implantation, surgeons can lengthen the Achilles tendon if it is short and also shorten the tibialis tendon.

About three weeks after the operation, the child is in a cast, after which he begins to wear special orthopedic shoes, which are made to him according to new standards, taking into account the results achieved by surgeons. After a year and a half, the implant is removed. The correct position of the feet is then maintained.

Before 8 years old, they try not to do the operation for children, there is no special sense, because the preschooler's leg is growing rapidly.

It is important to have time to operate on a child who needs it before the age of 16-17, since after this age the plasticity of bones decreases, and the likelihood of completely correcting the pathology even with the hands of a very good surgeon is rapidly decreasing.

After the operation for a long time, the child will have to undergo treatment, which in fact will resemble the conservative therapy described above. Massage, gymnastics, exercise therapy, physiotherapy and an active lifestyle will literally help you get back on your feet. Moreover, getting up correctly is smooth and comfortable.