The term "valgus deformity of the feet" refers to a pathological condition in which the height of their arches decreases. At the same time, their central axis is bent. In patients with a similar diagnosis, the heels and toes are bent outward, and the middle section of the foot is littered inward. This pathology is most often diagnosed in newborns and primary school children. In adults, as a rule, hallux valgus develops. In this case, women are most susceptible to pathology. They often develop a curvature of the joint of the thumb. If disturbing symptoms occur, you should consult an orthopedist. Based on the results of the diagnosis, a treatment regimen is compiled.
Causes
Hallux valgus deformity of the foot can be both congenital and acquired in nature. According to statistics, pathology accounts for up to 80% of all visits to an orthopedist. As a rule, small children and schoolchildren suffer from it. In adults, valgus deformity of the foot is diagnosed in isolated cases.
Congenital pathology is characterized by a violation of the intrauterine development of the child, in which the shape of the bones of the distal parts of the legs changes, as well as their relative position.
The causes of this condition are as follows:
- hereditary predisposition;
- various complications during pregnancy.
Valgus foot deformity of an acquired nature develops against the background of a weakening of the muscle tissue tone and due to underdeveloped tendons and ligaments. The causes of such disorders are the following diseases and conditions:
- pathology of the musculoskeletal system;
- improperly selected or poor-quality shoes;
- frequent episodes of SARS;
- dysplasia;
- rickets;
- overweight;
- genetic predisposition;
- various kinds of injuries;
- endocrine diseases;
- polio;
- Cerebral palsy.
An important provoking factor is the desire of parents to quickly teach the child to walk. Due to the low muscle tone, flattening of the arch of the foot occurs under its own weight. The logical result is an even greater weakening of tissues and ligaments. In the future, the child can no longer hold the foot in a normal position.
In adults, hallux valgus in most cases develops when wearing uncomfortable shoes. According to statistics, in countries where it is customary to walk barefoot, pathology practically does not occur. Following fashion trends and an excessive love for high-heeled shoes lead to excessive friction, pressure, pinching of nerve fibers and inflammation. Against the background of these conditions in adults, hallux valgus deformity of the big toe most often occurs, sometimes its arches are omitted, as a result of which it acquires an X-shaped appearance.
In addition, provoking factors are:
- Age. In just 3% of people, the disease develops up to 30 years. This indicator increases to 9% by 60 years. The likelihood of pathology doubles in people older than 60 years.
- Hereditary predisposition.
- Injuries.
- Overweight.
- Occupation. Most often, deformity is diagnosed in ballerinas, who are forced to dance on toes for a long time.
- Associated diseases. These include: gout, cerebral palsy, rheumatoid arthritis, articular hypermobility, Charot's disease, multiple sclerosis.
- Pregnancy.
- The period of menopause in women and the accompanying hormonal imbalance.
The main reason for the development of pathology is also the weakness of the muscular-ligamentous apparatus. If you continue to wear uncomfortable shoes, the disease will progress. In advanced cases, the question of the feasibility of surgical intervention is decided.
Symptoms
Pathology is easy to detect on your own. In children, hallux valgus deformity of the foot parents can identify as follows: to straighten the child's knees and tighten them tightly. If the gap between the inner sides of the ankles is more than 5 cm, this indicates the presence of a pathological process. In this case, the arches of the feet are noticeably obstructed inward, their height can also be reduced. Toes and heels in the presence of an ailment are deflected outward.
In addition, the following conditions are symptoms of hallux valgus in children:
- Shuffling while walking.
- The rapid onset of feelings of fatigue during outdoor games.
- Pain in the legs and back.
- When walking, the child steps only on the inside of the foot.
- Uncertainty about the gait.
- Muscle cramps in the calves.
- By evening, the feet are slightly swollen.
If you pay attention to the shoes worn by the child, you will find that the sole is most worn on the inside.
In adults, in the presence of hallux valgus of the foot or thumb, the following symptoms appear:
- Pain
- Rapid onset of feeling tired when walking.
- Marked outward deviation of the thumb.
In addition, there are problems with the selection of shoes. With severe deformation, the second finger also begins to shift. Due to this, pain occurs during walking and in it.
Severity
Specialists classify the disease depending on the angle between the bone and the first finger.
Pathology can have the following degrees:
- I. It is characterized by the occurrence of subluxation of the foot, which is a consequence of joint deformation. It develops against the background of pathological mobility of the ligaments.
- II. At this stage, an even greater displacement of the joints and tendons on the thumb occurs.
- III. Hallux valgus deformity of the 3rd degree foot is the most severe. At this stage, the connective and bone tissue can no longer cope with the load. They are maximally weakened and vulnerable to various kinds of injuries.
At the initial stage, the disease can be eliminated by conservative methods of therapy. With pathology of 3 degrees, some patients are shown surgical intervention.
Diagnostics
The treatment of hallux valgus deformity is performed by an orthopedic surgeon. It must be addressed when the first alarming signs occur.
In the process of admission, the doctor conducts an initial diagnosis, including:
- Interview. The specialist needs to provide information about all the available symptoms and clarify how long they appeared, and also in what situations their severity increases.
- Inspection The doctor assesses the condition of the foot: the position of the joint, other deformities, the position of the arches. After that, he asks the patient to take several steps. This allows the doctor to identify the severity of pain, swelling, changes in joint flexion. In addition, the orthopedist assesses the condition of the skin and draws attention to the peripheral pulse. In children under 3 years old, the middle part of the foot has a kind of fat pad. In order to evaluate the shape of the arch in a child, a specialist may ask him to stand on his toes.
After the initial diagnosis, the doctor directs the patient to radiography. Using this study, it is possible to determine the degree of deformation. In order to exclude the presence of other pathologies, a specialist can prescribe a CT scan. An ultrasound scan is necessary if blood circulation is suspected. Laboratory diagnostic methods (blood and urine tests) are prescribed to exclude the presence of associated diseases before surgery. For an accurate diagnosis in a child, the doctor can refer him to a consultation with a neurologist. This is necessary to exclude disorders from the nervous system.
Conservative treatments
Pathology requires an integrated approach. Patients need to understand that it is almost impossible to get rid of a grade 3 disease in conservative ways. But the decision regarding the feasibility of surgical intervention is made on the basis of the diagnostic results and the inefficiency of non-surgical methods.
The treatment plan for hallux valgus deformities of the foot includes the following methods:
- Immobilization.
- Massage.
- Kinesiotherapy.
- Physiotherapy.
- The correct selection of shoes and installation of orthopedic insoles in products.
- Other physiotherapeutic procedures.
Immobilization of the foot is understood as its forced reduction into the physiological position with subsequent fixation. The method is carried out using plaster or splices. In the first case, the immobilization procedure is carried out once a week. After removing the old gypsum, the foot is massaged and fixed with a new one. Longeta is a removable device. In terms of rigidity, it is not inferior to gypsum, but the degree of immobilization in it is lower. Fixing devices are intended for the treatment of 1 and 2 degrees of the disease. They must be worn for at least 12 hours a day for 6 months.
Massage with hallux valgus is performed by a specialist. It is not recommended to carry it out at home, so as not to aggravate the situation. For maximum effectiveness, you must complete a course of 10 sessions. With severe pathology, it is repeated several times a year.
In the past few years, kinesiotapeing has gained widespread popularity. With valgus deformity of the feet, the method helps to strengthen the muscle tissue that controls the affected joint. The essence of the method is as follows: a special tape with a sticky layer (kinesiotape) is applied to the pathologically altered zone. During the movement, it contributes to a change in muscle dynamics. The goal of the method is not to fix the foot, since the density of the kinesiotape is not much higher than that of ordinary adhesive tape. This method is auxiliary and is not used to treat severe pathology.
In both adults and children with hallux valgus, gymnastics helps to warm up muscle tissue and expand the range of motion. Exercise is recommended to do as often as possible. Their implementation does not require special training and equipment.
The following exercises are effective:
- In the sitting position, pull the socks towards you.
- In the same position, gently press the outer edge of the foot. At the same time, it should bend inward.
- To make rotational movements in feet.
- Walking on toes.
- Throw many small objects on the floor. Try to collect them with your toes.
- Move on the outside of the feet.
- Walk without shoes on uneven surfaces.
With valgus deformity of the feet, exercise therapy also improves the degree of coordination of movements, accelerates local blood circulation, and positively affects the contractility and tone of muscle tissue. The best result can be achieved by combining exercises with physiotherapeutic procedures.
These include:
- electrophoresis;
- paraffin therapy;
- amplipulse;
- magnetotherapy;
- mud baths;
- acupuncture.
These procedures are designed to minimize the severity of unpleasant symptoms. As an independent method in the treatment of pathology, they are not used.
With hallux valgus, shoes are important. Proper children's products must meet the following requirements:
- The ankle should have a good fixation (laces, fasteners, Velcro).
- Quality shoes are made from materials of natural origin.
- The back should be high (ideally covering the ankle) and stiff. When pressed with a finger, dents should not form.
- Heel height should be 0.5-1 cm.
- The inner edge of the right shoe is always straight.
- The toe of the models should be rounded.
- When bent, the sole of high-quality products without effort takes the form of an arc. It should also have a relief structure.
Shoes for the child must be purchased strictly in accordance with the size. Too tight or loose products lead to many pathologies of the musculoskeletal system.
Adults are also advised to purchase shoes made from natural materials. It should be comfortable and in size. Women are not recommended to wear products with a heel height of more than 7 cm.
In addition, doctors advise to wear insoles all the time with hallux valgus deformities of the feet. These orthopedic products allow you to get rid of pathology at an early stage of its development. As a rule, they are used in conjunction with instep support, finger correctors and additional screeds.
With pronounced pain, the doctor prescribes the use of non-steroidal anti-inflammatory drugs.
Surgical treatment
Surgical intervention is performed when all methods of conservative therapy were ineffective and did not stop the progression of the pathology. In adults, it is carried out if the disease significantly reduces the quality of life of patients and is a pronounced cosmetic defect.
The treatment of valgus deformities of the feet can be carried out in the following ways:
- Installation of the Kirschner needle. The design throughout life fixes the arch of the foot in a physiological position.
- Achilotomy. It involves cutting a tendon, with which triceps of the lower leg are attached to the calcaneus. Then the foot is fixed with gypsum. During immobilization, the tendon is restored and acquires a physiological length, since with pathology it is always shortened.
During the recovery period, physiotherapeutic procedures are shown in combination with massage and exercise therapy.
Alternative methods of treatment
It is important to understand that non-traditional methods are not able to get rid of the pathology or stop its development. Their task is only to eliminate pain. For this purpose, you can use various compresses. Propolis, applied for several hours to the affected surface, relieves pain well. The following remedy is also effective: pour dried and maximally chopped dandelion flowers with a small amount of iodine. Duration of infusion is 3 days. After this time, the product must be applied to the affected area in the form of a mesh.
Forecast
In most cases, it is effective to treat hallux valgus without surgery. Fast and best results can be achieved by contacting an orthopedist when the first alarming signs appear.
When ignoring the problem, both children and adults develop a pronounced deformation, which significantly reduces the quality of life. In addition, there are all kinds of disorders of the musculoskeletal system, which is extremely difficult to get rid of.
Preventive actions
From the first months of life, it is recommended to engage with a child in the pool. Swimming strengthens and develops muscles, and feet in the water never tumble in one direction or another.
In addition, the occurrence of pathology can be prevented by observing the following rules:
- regularly visit a pediatrician and orthopedist for the purpose of preventive examination;
- do not force a small child to walk if his body is not yet ready for such a load;
- purchase quality shoes and strictly in accordance with the size.
Adults also need to learn how to choose the right products that do not compress the foot, but are not too loose. Women are not recommended to wear high-heeled shoes. In addition, it is necessary to revise the regime of the day in such a way that several hours are allocated for a full rest. It is also important to control body weight, preventing the development of obesity.
Finally
Hallux valgus is a widespread orthopedic pathology. Most often it is diagnosed in children. In adults, as a rule, deformity of the big toe develops. In both cases, a comprehensive therapeutic approach is indicated. With its inefficiency, which happens in very advanced cases, surgical intervention is indicated. The main preventive measure is the correct selection of shoes.