Diseases of bones and joints are widespread in the world. They can develop at any age, more often they are affected by older people. However, there is a group of diseases that are congenital or acquired in early childhood. An example is valgus deformity of the knee. The pronounced curvature of the legs is visible with the naked eye, it makes it difficult to move and leads to disability. Knee deformity in childhood is treatable. Therefore, the disease should be diagnosed in the early stages. An orthopedic surgeon is involved in the treatment of this disease.
What is valgus and varus deformity of the knee joints
Curvature of the knees is one of the most common pathological phenomena among orthopedic diseases. It can be of 2 types: X- and O-shaped. In most cases, deformation occurs during bone growth, that is, in childhood. Sometimes the knees bend in the elderly. This is due to the increased load on the osteoarticular system and the development of osteoporosis. Timely treatment of curvature gives a positive result. However, if measures are not taken, the disease can lead to disability. The curvature of the legs in the form of the letter “X” is called hallux valgus. It can be either two-sided or one-sided. The diagnosis is made on the basis of examination and measurement of the distance between the legs. With hallux valgus, it is at least 5 cm. The patient should keep his legs as low as possible and stand level while measuring the distance.
Varus deformity is an O-shaped curvature of the knees. The reason for its development is the weakness of the skeletal system. Like hallux valgus, varus deformity can occur at any age. For both pathologies, treatment by an orthopedist is required.
Causes of hallux valgus in children
Hallux valgus deformity of the knee joints is not an independent disease, but a consequence of some pathological condition. Curvature always occurs against a background of bone pathology. The causes of knee deformity include:
- Congenital malformations of the joint.
- Vitamin D deficiency
- Increased physical activity during bone growth.
- Knee injuries.
- Calcium deficiency in the body.
- Chronic joint diseases.
- Excess weight.
Hallux valgus deformity of knees in children often occurs against the background of rickets. This disease is characterized by inadequate intake of cholecalciferol - vitamin D. Due to the deficiency of this substance, bone tissue is not fully strengthened. As a result, any physical activity in childhood leads to the curvature of large joints, especially the knee joint. Most often, the deformation becomes noticeable by 2-3 years, when the baby's gait is already formed.
Congenital abnormalities include shortening of the femoral muscles, curvature of the lower leg bones, and underdevelopment of the knee joint. When these malformations are identified, it is necessary to start treatment with an orthopedist in a timely manner and control physical activity so that the deformation does not progress.
Due to the high pressure on the knee joints, curvature can also occur in children who do not suffer from rickets and developmental abnormalities. The fact is that cartilage and muscle tissue grows more slowly than bones. Therefore, skeletal muscle and ligamentous apparatus are weaker. Constant loads lead to a gradual deformation of the bones of the lower leg and thigh.
Adult knee curvature
In some cases, hallux valgus deformity of the knee joints in adults may occur. More often this happens in people suffering from hip muscle hypotrophy. Muscle weakness of the legs can occur after a neurological pathology, such as a stroke.
In women, knee deformation often occurs during postmenopausal women. In old age, due to a lack of sex hormones, osteoporosis develops. This pathology is associated with "leaching" of calcium. Due to its deficiency, bone tissue becomes discharged and brittle. Therefore, habitual physical activity can lead to curvature of the supporting joints. In most cases, deformation occurs in people with increased body weight.
Risk factors for the development of valgus curvature of the knees are joint and bone pathologies. Among them are chronic inflammation of the knee joint (arthritis). Most often they occur against the background of injuries or infectious lesions. Another common pathology leading to deformation is gonarthrosis. It is characterized by a change in the structure of cartilage. Specific pathologies that cause deformation of the knees include gout, ankylosing spondylitis, rheumatoid arthritis and other systemic lesions of the connective tissue.
Stages of Hallux Valgus
Hallux valgus deformation of the knee joints is divided into several stages. This depends on the location of the mechanical axis relative to the lateral condyle. You can determine the degree of curvature by the X-ray picture. In addition, the doctor measures: how many degrees the lower leg is bent outward. The following stages of deformation are distinguished:
- Easy degree. It is characterized by the fact that the mechanical axis, carried along the entire leg, is located along the center of the lateral condyle of the femur. The lower leg is rejected outward by 10-15 degrees. In addition, the mechanical axis passes through the middle of the outer half of the tibia condyle.
- Medium degree. The mechanical axis of the leg affects the outer part of the lateral condyle of the thigh. The angle of the leg deflection is 15-20 degrees. In addition, the axis touches the external condyle of the tibia only with the edge.
- Severe degree. It is characterized by the fact that the knee joint remains outside the passage of the mechanical axis of the leg. The tibia is deflected outward by more than 20 degrees.
Establishment of the stage of valgus deformity of the knee is necessary. Treatment tactics depend on the severity of the curvature.
Symptoms of knee deformity in children
Parents often ask the question of when the hallux valgus deformation of the knee joints begins to appear in children? The age of the child is important to consider when making a diagnosis. Indeed, in children under 2 years of age, a slight deformation of the knees is considered a normal option. This is due to age-related features of the muscular system. Symptoms of hallux valgus deformity include:
- “X” curvature of the legs. To clarify the diagnosis, it is worth measuring the distance between the ankles. With pathology, it exceeds 5 cm.
- Fatigue when walking. Children suffering from bending of the knee joints are constantly asking for their hands.
- Discomfort in the legs when walking. Children may complain of pain in the knee.
It is important to notice in time that the child has a hallux valgus deformity of the knee joints. Photos of such a curvature can be seen on medical sites or in the literature on pediatric surgery and orthopedics. If the change in the shape of the legs resembles the pathology observed in the images, you should consult a doctor.
In addition to the listed symptoms, symptoms of the underlying disease are noted. With rickets in young children, baldness of the occipital region, flattening of the abdomen and chest are observed. A large fontanel on the head does not overgrow for a long time. Rickets is often combined with anemia, manifested by a pale skin, weakness. Hallux valgus is more prone to children with increased body weight.
Diagnosis of valgus curvature of the knees
How is hallux valgus deformity revealed? X-rays are considered the main method for diagnosing leg curvature. After receiving the images, the doctor conducts the mechanical axis of the leg and determines its position. If the line is deviated from the middle of the knee joint, then there is a curvature. To suspect pathology, it is enough to look at the shape of the child’s legs and measure the distance between the ankles with closed legs and feet. According to the x-ray picture, another indicator is measured - the angle of deviation of the bones. If it is more than 10 degrees, then there is a curvature.
In addition to detecting deformation, its cause should be established. For this, laboratory diagnostics are performed. It is important to determine the level of calcium and phosphorus. To exclude articular pathologies, a biochemical blood test is performed. Evaluate indicators such as the presence of C-reactive protein, rheumatoid factor, uric acid level.
Hallux Valgus: treatment of pathology
Timely help of a doctor with hallux valgus can lead to a complete correction of the shape of the legs and stop further curvature. With severe deviation of the knees, surgery is performed. Conservative methods of treatment include:
- Massage and exercise therapy.
- Physiotherapeutic procedures.
- Wearing orthopedic shoes and special fixators of the knee joint.
In addition, etiotropic therapy is important. Children under 3 years old should receive vitamin D and spend time in the sun. Adults who are deficient in calcium are prescribed this mineral in pill form.
Massage for curving knees in children
One of the main treatment methods is massage. The hallux valgus deformation of the knee joints in the early stages in children can completely disappear due to the mechanical effect on the muscles and exercise therapy. The course of massage should be 2-3 weeks. Then take a break for 1-2 months. Then the course of procedures is repeated again. Massage consists in stroking and rubbing the lower back, sacral region, back surface of the lower leg and thigh. Then, various passive movements in the leg are performed, aimed at changing the position of the joint. During massage, special attention should be paid to the internal condyle. You should try to gradually bring it into a normal position.
Physical therapy for knee bending
Exercise plays an important role in pathology such as hallux valgus deformation of the knee joints in children. Treatment gives a positive effect. The complex of exercises includes: active flexion and extensor movements in the joints, rotation of the legs. It is recommended to walk on toes, squat with divorced knees, and sit in Turkish. Regular exercises and massage lead to the correction of the shape of the legs by 4-5 years.
Surgical treatment of deformity
Surgical treatment is indicated for severe deformity. A similar method is performed if other methods fail. Surgical treatment consists of artificial bone fracture and fixation of the joint in the desired position. However, such operations cannot be performed during a period of intensive growth.
Prevention of curvature of the knee
To prevent hallux valgus deformation of the knee joints, it is worth observing preventive measures. These include:
- The use of foods and vitamin complexes rich in calcium.
- The introduction of a preventive dose of vitamin D from 1 month to 3 years.
- Daily walks with a child.
- Rational physical activity.
Adults are advised to control body weight; if pain in the joints appears, consult a doctor.