Hallux valgus in children

X-shaped curvature of the legs or hallux valgus deformation of the knee joints is several times less likely than the same pathology of the feet. This disease is capable of rapidly developing. If you do not consult a doctor on time, it will lead to a limitation of the motor ability of the lower extremities. The only way out of this situation will be the operation and the subsequent long rehabilitation period.

Causes of hallux valgus deformity of the knee

The child’s curvature of the legs can cause congenital pathologies of the patella, ankle deformities and shortened ligaments.

In the risk group, people who have a significantly higher probability of occurrence of pathology are children and elderly patients. Hallux valgus deformity of knees in children is formed as a result of too early attempts of independent walking, when the skeletal system has not yet become stronger, and the joints get a heavy load. A slight curvature of the joint passes independently by the age of 8. Less commonly, the child’s knee deformation is congenital. This happens due to pathologies of the development of the fetus even in the womb due to the influence on the maternal body of adverse conditions, toxins, stress, drugs and injuries received during pregnancy.

In old age, joint deformation is the result of osteoporosis or a fracture of the femoral neck. Less commonly, it occurs due to age-related changes in the skeletal system, deterioration of bone strength and flexibility of the ligaments, and the associated increased load on the joints. But, this pathology sometimes manifests itself in adults due to such reasons as:

If you wear shoes with heels, then the likelihood of developing such a deformation increases.

  • obesity;
  • rickets;
  • wearing shoes with heels;
  • congenital and acquired joint pathologies;
  • lack of vitamin D and calcium in the body;
  • injuries: fractures, dislocations, ruptures of ligaments with necrotization;
  • diseases that adversely affect the musculoskeletal system.

How to recognize a disease?

A person can suspect valgus of the knee joints by observing one of the following symptoms of valgus deformity:

  • the appearance of pain in the legs when walking or running;
  • the shape of the legs resembles the letter X;
  • pain in the knee joints;
  • the appearance of flat feet;
  • gait disturbance;
  • “Shuffling” when walking.

With this pathology, the picture of the joint gap changes.

If one of these signs is detected, the doctor prescribes the patient to undergo an X-ray, in the picture of which the curvature of the joint space and excessive ossification of the joints and bones of the limb are visible. Diagnosis without x-rays is also sometimes possible. The patient is placed on the couch and the lower legs are brought together: the farther the feet are from each other, the harder the degree and more difficult the treatment. To make a final diagnosis, the doctor puts a mechanical axis on the leg and determines if there is a deviation from the middle.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Degrees of curvature

Determining the stage of deformation with hallux valgus is necessary to compile a complete picture of the disease. Based on the magnitude of the curvature of the joint, there are three degrees of development of pathology, which are described in more detail in the table:

StageDeviation radius, degree
110-15
216-19
3More 20

The difference between hallux valgus and varus is that valgus can only be X-shaped, and varus can be O-shaped.

Treatment of the disease

The sooner the patient went to the doctor, the easier and easier it will be to correct the defect. One method to get rid of the disease will not work. The treatment of hallux valgus includes a set of therapeutic and preventive measures: massage, physiotherapy, physiotherapeutic procedures, the wearing of special orthopedic insoles and bandages, and the alignment of the limb surgically.

Massage and exercise therapy

The normal functioning of the joint is affected by the condition of the muscles in close proximity to it. If he is affected by pathology and the muscles are relaxed, then the disease progresses faster. Massage with hallux valgus includes not only the study of the inner and outer surfaces of the thigh, but also the spine, lower back and gluteal region. During the session, the muscles must be flexed, stretched, and the joint is massaged in order to bring the lower leg to a normal position. It is advisable to undergo a massage session every day for 2-3 weeks, and then take a break for a month.

The physician develops a set of exercises for physiotherapy exercises for each patient separately. Exercise therapy is effective only when exercises are performed systematically, daily. This complex includes training involving the knee joint: squats, knee rotation, elevation. Constant exercises bring the muscles into tone, which prevents the disease from progressing.

Orthopedics

Hallux valgus curvature involves wearing an orthopedic bandage – splint. This is a special knee joint retainer that preserves the anatomically correct position of the limb. The design of the bandage covers the leg from the foot to the hip. It is made for each individually and is worn only at bedtime. Another bandage is put on during the day – an orthosis. Its function is to reduce the load on the knee joint. Excessive pressure on the feet is neutralized by the obligatory wearing of orthopedic shoes that tightly fix the ankle.

Physiotherapeutic procedures

Muscle electrical stimulation is prescribed as a therapeutic measure. An electric current of up to 50 mA and duration from 0,5 to 300 ms is supplied to the fibers. Such stimulation tone weakened muscles, strengthens them and improves blood circulation. After the procedure, the muscles acquire the ability to hold the joint in a normal position. You can not assign such a procedure to people in whose body there are severe inflammatory processes with elevated body temperature, tumors, thrombophlebitis develop.

Surgical correction

Hallux valgus in children does not reach a stage where surgery is indispensable. This method is used only for adults and elderly people, in whom the disease is often complicated by inflammation of the joint or curvature of the meniscus of the knee. The essence of the operation is that the surgeon deliberately makes a fracture to connect the bones and align the axis. Fixation of the leg is carried out using the Ilizarov apparatus, which is gradually twisted as it heals. You can’t immediately get on your feet: first walkers are used, then crutches.

preventive measures

In order not to provoke the development of curvature in a child, it is necessary to monitor the baby’s nutrition from an early age. It is desirable that his diet contains minerals, vitamins and trace elements necessary for the normal development of the body and skeletal system. If necessary, do vitamin D injections to prevent rickets in the first three years of life. It is recommended to spend more time outdoors in sunny weather. It is allowed to gradually accustom the child to physical activity commensurate with his age. Adults and older people can’t gain too much weight and visit an orthopedist if there is pain in the knee joints.

Hallux valgus

One of the most common diagnoses for orthopedic doctors is hallux valgus deformity of the knee. And although sometimes this ailment may seem harmless, but ignoring it can not only get unpleasant complications, but also bring the matter to disability. Often it manifests itself in early childhood. Therefore, parents who are concerned about the condition of the legs of their child should immediately contact a specialist. The sooner you start the fight against the disease, the better will be the prognosis of recovery.

What is pathology

The presence of valgus knees in a baby at an early age is regarded by specialists as a variant of the norm. In infants, the knee joints are in contact, and the legs are slightly apart on the sides. If there is no pathology for the development of articular tissues, then after some period of time the legs come to a normal state.

Violation can be on one or both sides. The most striking manifestation of the disease can be noticed when the baby begins to walk due to the increasing load on the lower limbs, which greatly affects the development of their shape. Ligaments of the child have not yet formed, and the foot is often involved in the process. The photo of the valgus deformity of the knee joints shows that the legs become similar to the letter X.

If the disease is not treated, then the spine will gradually take over the process. When the lesion is one-sided, it is even worse. In the list of causes of scoliotic curvature, valgus is almost in first place.

The formation of hallux valgus deformity of the knee joints in adults may occur. The elderly are at risk or have other pathologies of the musculoskeletal system, resulting in such deformations.

Why arises

  1. The formation of valgus deformity of knee joints in children sometimes occurs even in the womb under the influence of adverse factors. Then, at the same time, the curvature of the femoral neck, the installation of the tibia according to the valgus type and flat foot develop simultaneously. Maybe on one or both sides.
  2. The most common reason for the formation of hallux valgus in children is periods of rapid growth, while the ligamentous-muscular apparatus is not strong or weak for some reason. The load exerted on the legs during such periods exceeds their capabilities.
  3. Hallux valgus pathology in children can be caused by rickets. Especially if this ailment proceeds in a mild or imperceptible form. And also contribute to its development, Erlacher-Blount disease and other diseases affecting the musculoskeletal system.
  4. The legs may bend when the bone growth in the pineal gland is impaired in children.
  5. Contracting in the pelvic joint of the adductor type is a prerequisite for the occurrence of secondary deformity.
  6. The reason is the wearing of poor-quality shoes, which has a compressive effect on the foot and provokes an uneven setting of the foot. In adults, a narrow-nosed high-heeled shoe is a similar provocateur.
  7. Overweight provokes deformities of the legs, as it increases the load on them. It is especially bad when at the same time there is underdevelopment or weakness of the muscles and ligamentous apparatus.
  8. Various traumatic and inflammatory reactions in the joint also become a provocateur of hallux valgus curvature.

As manifested

Symptoms of valgus curvature of the knee joints are as follows:

  1. Visually, the knees, and with them the feet, are turned outward and flat feet are formed.
  2. In the process of walking, a person quickly gets tired, and painful sensations appear in the legs.
  3. In parallel, scoliosis is determined. Especially if the valgus is one-sided.
  4. If the disease is started, then changes in gait occur. The patient constantly shuffles while moving.
  5. If the deformation is congenital in nature, then in most cases, children have a curvature of the femoral neck.
  6. An x-ray shows the presence of a tapered external condyle of the femur with a violation of ossification.

Using X-ray examination methods, the stage of the valgus knees is established. Since treatment procedures differ at different stages, their establishment is very important.

In the valgus defect, mild, moderate and severe stages are distinguished.

  1. Easy. If the axis of mechanical purpose is drawn along the leg, it will be located along the middle of the femoral condyle from the lateral side and will pass through the center of the tibial condyle half located outside. The leg abduction angle will be from 10 ° to 15 °.
  2. Medium degree. The axis touches the outer edge of the femoral condyle from the lateral side and the edge of the tibial condyle located outside. The deflection angle will increase to 20 °.
  3. Heavy. The lead angle will exceed 20 °, and the axis will not affect the knee joint at all.

In addition to an X-ray examination, a laboratory is also carried out. Determination of the level of phosphorus, calcium, the presence of C-reactive protein, uric acid and rheumatoid factor in the blood helps determine the cause of the development of the pathology and correctly determine the therapeutic complex.

Hallux Valgus Treatment

In children, it is best to begin treatment of valgus of the knee joints before the time when the child begins to walk independently. But this statement is true only for congenital pathology.

The whole complex of therapeutic measures includes massage, exercises from the complex of physiotherapy exercises and yoga, the use of specialized orthopedic devices, as well as physiotherapeutic effects. The sooner treatment begins, the better the prognosis. If all of the above methods are meaningless, then resort to surgical interventions.

Massage

Reviews of massage procedures confirm their effectiveness in the treatment of hallux valgus. By working out the muscles surrounding the knee, they achieve joint stability. The bottom line is to relax everything that is tense, and strain everything that is relaxed. To achieve the best effect, it is necessary to massage the muscles of the back, as well as the gluteal and lumbar areas. The duration of the full course should be at least 15 procedures. Courses should be repeated at least a month later.

Therapeutic exercise

Positive progress when using physiotherapy exercises is possible only with daily exercise in several approaches. The first is recommended to be performed while relaxing muscle mass. Convenient for this time after the massage, during the day, the time for the second is chosen, and the third should be performed before going to bed. Only systematic training will strengthen the muscles to such an extent that they maintain the correct position of the knee. In the gymnastic complex with hallux valgus deformation of the knees, squats, overcoming hills, exercises for mixing or raising limbs are included.

It is unacceptable to make a set of exercises yourself. This should be done by a competent specialist.

Of the physical equipment recommended, such as the Swedish wall, clubs, a large ball and a gymnastic ladder. Horse riding, swimming and cycling are very helpful.

Orthopedic devices

After the diagnosis has been established, the first thing that an orthopedist prescribes for children is a device such as a splint. This is a special pad that fixes the foot, lower leg and thigh in a position that is correct from an anatomical point of view. Made to individual sizes. Dressed up all night.

The second effective device is called an orthosis. It is put on a knee joint in the afternoon. This reduces the strain on the knee that it experiences.

The wearing of these devices is controlled by doctors, and the degree of support for the joint is adjusted depending on the changes occurring in it.

An important therapeutic device is orthopedic shoes. It fixes the ankle joint and compensates for excessive load in this area.

Physiotherapeutic treatment

Of the physiotherapeutic procedures, the most effective in the treatment of knee deformation is the stimulation of muscle fibers by electric current. Passing impulses excite activity of a motor nature, due to which the muscles strengthen and increase mass. Blood circulation in tissues increases, which improves their nutrition.

Surgery

If the above manipulations did not produce any effect on the knee joints, they suggest a surgical method of therapy. Referral to this type of treatment is usually given to elderly patients. They have almost no chance of being cured by conservative methods. Surgery is also discussed if there is a deformation of the knee meniscus. Such a curvature cannot be eliminated in any other way.

During the operation, an artificial bone fracture and the application of the Ilizarov apparatus are performed in order to restore the correct axis of the lower extremities. In the period after the operation, anesthesia of the limb and strengthening of the muscles around the knee is carried out to maintain it.

Reviews

My child was diagnosed with valgus curvature of the knee joints. Determined as soon as he began to walk. We all that recommended, carried out. Went for massages, engaged in physical therapy and more. We did without surgery. Now the child is already 15 and with knees everything is fine. From past problems no trace was left.

I had a hallux valgus defect already in adulthood, I had to undergo surgery. I tried to do exercises and go for a massage, but this did not help me anymore. It was scary, but my doctor managed to convince me of the need for such treatment. The first time after the operation, the legs were very painful and I had to take painkillers. I was required to do special exercises to provide support for the knee joints, and to lose weight. But I was satisfied with the treatment and although I have to work a lot on myself, I feel much better now.

Correction of valgus deformity of knee joints in children: signs in the photo, causes, treatment and prevention

If joint problems are practically normal for older people, then for children knee deformation is not only an unaesthetic appearance and cause of complexes, but also a provocateur of health problems in the future. In children, curvature of the legs, called valgus and varus deformity, is often found. Ailments can be eliminated, but they should be diagnosed in time and undergo appropriate therapy.

Valgus and varus deformity of the knee

Active bone growth is a good time for knee deformation. As a result, it is often found in babies, which requires timely treatment. Otherwise, serious violations may occur with age.

There are two types of curvature of the knee joints:

Causes of deviation in children

There are many factors that can provoke problems with the knee joints. The disease can be hereditary and acquired.

The most common causes of curvature:

  • congenital malformation;
  • bending when a child is born;
  • children’s legs are heavily loaded, with rapid growth, the ligaments do not have time to fully develop;
  • the presence of concomitant diseases such as rickets, Blount disease or paralysis;
  • pelvic bone injuries;
  • the child wears uncomfortable shoes, which squeezes the feet, provoking incorrect positioning of the legs;
  • overweight;
  • knee injuries;
  • inflammation of the joints of the knees;
  • poor environmental conditions.

Stages and symptoms of hallux valgus

Valgus can be recognized by:

Varieties of hallux valgus regarding its degree:

  1. Easy. The mechanical axis is located along the center of the lateral protrusion of the femur and in the m />Medium. It differs in the passage of the axis through the external part of the lateral protrusion of the femur and its contact with the lateral edge of the external protrusion of the tibia. Shin displacement occurs by 15-20 degrees.
  2. Heavy. The axis is located outside the knee joint. The tibia is displaced by more than 20 degrees, which is noticeable in the photo below.

Diagnosis of pathology

The primary diagnosis of valgus is a visual examination of the lower extremities. The child must be placed so that the legs are parallel, and the knees and feet are aligned. Next, measure the space between the ankles. If it is more than 3 cm, pathology can be suspected.

It is also important to identify the factors that triggered the disease. For this purpose, laboratory studies are carried out. It is required to pass tests for rheumatoid factor, CRP, biochemistry, phosphorus and calcium.

Treatment and prevention

To prevent and treat valgus in children, primarily physical and chemical methods are used:

  • massage to tone the muscles and return them to normal;
  • LFK complex (squatting on a ball, picking up pencils from the floor with toes, Squats “Spring” and with crossed legs);
  • physical activity in the form of swimming, yoga, cycling, Pilates;
  • intake of vitamin complexes with a sufficient content of calcium, phosphorus and B vitamins;
  • the use of anti-inflammatory drugs in the presence of inflammation;
  • taking analgesics for severe pain.

With serious pathologies in children, orthopedic products that are attached to the knee joint are used for treatment. They reduce the load on the legs and fix them in the correct position.

If the above methods did not give the desired effect, surgical intervention is required, which is very rarely shown to small children. Usually, surgery is avoided.

Modern knowledge of hallux valgus

Hallux valgus is not only found in children and the elderly. Valgus can begin in humans at any age. If you do not start treatment for curvature at an early stage, the disease can lead to severe deformation of the knee joint.

At the same time, the legs will look extremely unaesthetic and will take an X-shape. Can curvature be cured? And if so, what needs to be done?

Is valgus deformity dangerous or not?

It is generally accepted that a slight deformation of the knee joints in children, when they are in infancy, is quite a common, normal phenomenon. In children, indeed, the knees are brought together, and the legs are set aside. Over time, the condition of the knee joints returns to normal. Such their deformation is not dangerous and does not have negative consequences for a growing child if its joint tissues develop normally.

There are two types of deformation:

When the child does not bend the knees, the parents begin to sound the alarm. And in this they are 100% right. If valgus does not begin to be treated in childhood, it can bring a lot of trouble as a child grows up. Hallux valgus deformation of the knee joint tissue becomes most noticeable when the baby begins to walk independently. At this age stage, the curvature is due to the increasing load on the child’s legs.

At this time, the baby’s muscles and ligaments have not yet formed. The weight of the upper body presses on the area of ​​the knee joints. It is important to know: when a child has a hallux valgus, it may not stop in only one area of ​​the knee joint. Valgus is often “moved” from the knee joints to the feet and covers their joint tissue. The presence of such a disease leads to the fact that the deformation of the legs in the area of ​​the foot becomes even more noticeable. Deviation of the heels outward and the X-shaped shape of the legs are a common variant of the manifestation of the disease.

The degree of curvature of the legs in the patient

Hallux valgus can cause problems associated with curvature of the spine. Valgus does not always affect both limbs at the same time. Curvature can occur in one joint. In this case, as the disease progresses, the spinal column begins to change not for the better. Valgus and scoliosis are closely related. This deformation is one of the reasons for the onset of scoliosis.

The curvature of the legs in children and the deformation of the knee joints does not pass without a trace for a growing organism. Often feet are affected. The older a person becomes, the more flat-footedness is manifested in him.

In people who were diagnosed with a “knee joint curvature” in childhood, flatfoot usually begins to develop dynamically. As they get older, children often complain of leg pain.

How to help the child

What recommendations do parents need to follow so that the condition of their baby’s knee joints gradually returns to normal? First, a child who has valgus should not be allowed to stand for long periods with legs spread wide. Secondly, it is necessary to reduce the number of leg games.

If timely measures are not taken, the deformation of the knee joints will not stop. When there is a suspicion of valgus, you should immediately contact a medical institution, where the child will be provided with qualified assistance. For their part, parents will also need to take measures to ensure that such deformation is successfully stopped.

If the baby has a hallux valgus, you will have to give up walking. Is he just starting to walk? He will have to regulate his walks until the valgus and its symptoms are eliminated.

Very useful massage, which is the best method of treating this ailment of the knee joint. Procedures must be performed by a professional. The course of massage is at least two weeks. After 1-2 months, the sessions must be repeated.

If a massage is given to a nursing baby, then it must be based on the fact that exposure should bring only pleasure to a small patient. Before carrying out such a procedure, a paraffin wrap is done so that the baby’s legs are warmed up.

It is believed that hallux valgus often develops due to improper footwear. It really is. Poor-quality, improperly made shoes can create the preconditions or aggravate modifications of the knee joints. If an adult or a child has a hallux valgus deformation of the knee joint, which proceeds easily and is at the initial stage, massage and orthopedic insoles will help to cope with the disease.

Overheating or hypothermia of the knee joints is unacceptable. They have the property of accelerating the deformation of surrounding tissues. In some cases, doctors prescribe children and adults tires for fixing the knee joints. These orthopedic appliances are used during sleep.

Can legs be restored aesthetically pleasing

Surgical intervention is carried out only as a last resort. To correct the deformation of the knee joint, the emphasis is primarily on non-drug methods and physiotherapeutic procedures. The disease is also treated with traditional medicine.

Children and adults healers recommend walking in the summer on grass or sand. It is considered to be. that in such cases, valgus deformity is faster. It is equally useful for the child to play ball games at this time. Exercise helps to quickly get rid of such an ailment. If the baby is invited to raise the ball in the prone position with his legs without the help of his hands, this simple game will bring him pleasure and health benefits.

If the pathology is not pronounced, it can help:

  • Exercise therapy
  • massage;
  • wearing orthopedic shoes.

Complex treatment will help to defeat the disease in a child by about 4 years old. In adults, alas, the treatment of valgus lasts much longer. If a person begins such an ailment in adulthood, specialists, as a rule, advise resorting to surgical treatment. This is due to the fact that in people with age, this pathology is more severe and may be accompanied by inflammatory diseases in the joints and periarticular tissues.

Morozov Georgiy

Georgy Morozov, rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases.

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