Feet “X” in a child (what to do in the presence of such an ailment is described below) is a valgus deformity of the foot. Pediatricians often call this condition borderline, or transitional. With sufficient physical activity, conducting massages and performing special exercises, the child’s legs straighten by two or three years. In some cases (such only 7%), surgical intervention may be required.
Hallux Valgus Symptoms
"X" -shaped legs in children who have just learned to walk can be seen quite often. Hallux valgus deformity of the foot is diagnosed when, with tight compression and straightening of the knee joints, the distance between the ankles is more than four to five centimeters. The fingers usually deviate to the outside, and the inner arches of the feet turn inward. In this case, pain in the joints occurs, the child quickly gets tired when walking, there are difficulties with the selection of the first shoes. Similar symptoms occur with arthritis, deforming osteoarthrosis, gout. Hallux valgus can be not only X-shaped, but also O-shaped. If pathology is accompanied by a decrease in the height of the arches, then we are talking about flat-valgus deformity. This form of pathology is most often found in pediatric orthopedics.
How to independently determine the curvature
Does a child have “X” legs per year? This should not cause concern for parents if the baby has just started to walk confidently. As soon as the child learns to move independently, you need to monitor his posture and gait. It is at this time that the prevention of scoliosis and flat feet can begin. Often young children walk, bringing their knees together. In this case, the baby only steps on the inner edge of the foot. To check if there is a pathology, you can ask the baby to stand upright and put his legs together. The knees converged, but below the leg diverge by five centimeters or more? In this case, we can talk about hallux valgus. It is advisable to consult a doctor in order to correct the deviation in time.
Hallux valgus develops gradually. In adulthood, a child may complain that he is not comfortable wearing shoes. At the end of the day, pain in the feet may appear, the first toe is bent, the bone significantly deforms the anterior section. The sole usually protrudes in the center, flattened. Often in this place there are quite painful corns that impede movement. The second finger can rise slightly upwards, over time it ceases to expand, a callus forms. Deformation disrupts the blood supply, which contributes to the development of arthrosis.
Causes of Hallux Valgus
Why do children have “X” legs? This may be a congenital or acquired pathology. With unfavorable heredity, the curvature of the legs is most often caused by structural features of the child’s body, which are laid at the genetic level. The feature is passed from parents to children. Often this curvature can only be corrected with surgery. In this case, the child will have “X” legs for 2 years of life, although the pathology should already have passed by this age (with appropriate treatment). O-shaped curvature due to adverse heredity does not occur in medical practice.
As Dr. Komarovsky notes, the legs of the "X" in a child at 2 years old are often the result of rickets. This disease is associated with a lack of vitamin D in the child’s body and is characterized by impaired bone formation, mineral metabolism in bone tissue. Rickets is accompanied by multiple changes from the musculoskeletal system: not only the legs bend, but also the flat bones of the skull soften, the chest is deformed, the tubular bones and the spine are bent.
The prevalence of rickets in Russia is 80% among premature babies and 54-66% among term babies. Adverse factors that provoke the disease are gestosis of pregnant women, rapid delivery, physical inactivity during pregnancy, a large body weight of the child at birth, excessive weight gain, limitation of motor mode (tight swaddling, ignoring massage). Two to three signs of rickets are usually found at an early age (three to four months) on examination by a pediatrician or pediatric surgeon. Due to the fact that the symptoms are not pronounced, pediatricians suggest considering this condition as borderline. Doctors reassure parents that the pathology is eliminated on its own as the body grows older.
The causes of hallux valgus may be weakness due to muscle hypotension, imperfection of the ligament-tendon apparatus due to prematurity or intrauterine malnutrition. Congenital connective tissue weakness is possible. Often the legs are "X" in children who suffer from acute respiratory viral infections, pneumonia, bronchitis. Disorders develop in babies against the background of cerebral palsy, polio, obesity, polyneuropathy, myodystrophy.
In some cases, pathology occurs after injuries of muscles, ligaments or bones of the leg and foot, prolonged stay of the limb in a limited state (gypsum, tight swaddling). Rarely, deformity is noted with dysplasia or a congenital dislocation of the hip. Feet "X" in children, who were early put on their feet, can be seen quite often. The use of walkers, driving by handles or improper selection of shoes can play a negative role (it is undesirable to buy used shoes for children that are too soft or have poor fixation of the foot).
Diagnostic measures
Legs deformed by "X" in children - (photo see in the review) at the age of ten to twelve months, parents usually notice, after which they turn to the pediatrician with a problem. To finally judge the presence of hallux valgus and the degree of its development, you need to consult a pediatric traumatologist, orthopedist or surgeon. How to fix the legs "X" in a child? A specialist will prescribe examinations to confirm the diagnosis, and then select the appropriate treatment. During a visual examination, attention is drawn to the deviation of the heel and toes outwards, the displacement of the inside of the foot and the smoothing of the arches inward.
To accurately determine the diagnosis, an X-ray of the feet, podometry and computer plantography are performed. Radiographs of the feet are performed in three projections. So you can see the change in the position of the feet in relation to each other. Plantography using computer methods allows you to calculate the morphological parameters of the foot. According to the results of the submetry, it is determined how the load is distributed to different parts of the foot. Clinical studies can determine the pathology when visually changes are still not noticeable. In some cases, an ultrasound of the joints is performed.
If the legs are “X” in the child, what should parents do? It is necessary to exclude the pathology of the central nervous system and PNS due to valgus deformity of the foot, so the neurologist should examine the baby. For example, poliomyelitis can provoke disorders in the development of the musculoskeletal system. If a concomitant diagnosis is found, treatment should be started immediately.
Treatment Methods Used
How to fix the legs "X" in a child? Physiotherapy exercises, massage courses, foot baths, mud applications, muscle electrical stimulation, paraffin therapy, limb immobilization and other treatment methods are used to restore the normal shape and functions of the foot, strengthen the ligamentous apparatus. Children with deformation need to select individual insoles or special shoes with rigid fixation, arch support.
If the children have X-shaped legs, treatment should be started as soon as possible. Such a pathology, discovered in the early stages, is much easier to correct. A vitamin D intake is prescribed. It is advisable to give the baby vitamin D in the first year of life to prevent problems with the musculoskeletal system in the future. Parents are advised to purchase orthopedic shoes for the baby, to take massage courses every three months and not to refuse physiotherapy, more often to be in the sun and to do physical therapy with the child.
Massage with deformation of the foot is carried out along with a complex tonic. Specialists pay a lot of attention to the lumbar spine, from where the nerve endings go to the muscles of the legs and buttocks. First, a lumbar massage is performed, then the masseur switches to the gluteal and sacral zones. The back side of the leg is massaged (lower leg, thigh, sole, Achilles tendon), and then the front. This helps to correct the shape of the foot to the correct position and strengthen the muscles. Strengthening the effect of massage helps exercise therapy.
Physiotherapy: electrophoresis with calcium
Electrophoresis is a popular procedure that is indicated for paralysis, upper respiratory tract diseases, muscle dystrophy, neuritis, orthopedic problems, myositis, hip dysplasia. During the procedure, electrodes are fixed in a specific area. Under them, a paper or fabric pad impregnated with a solution of calcium is preliminarily placed. In medical institutions, impregnation is usually done with a 0.9% solution of calcium chloride. The cost of physiotherapy depends on the duration of the course and the cost of consumable drugs.
Balanced diet
Hallux valgus is a pathology of the development of the musculoskeletal system, so the body especially needs calcium, phosphorus and vitamin D. It is necessary to saturate the child’s diet with dairy products, sea fish, eggs (yolk is especially useful), nuts, and legumes. These foods contain enough vitamins. It is advisable that these products are present on the menu regularly, and not occasionally. More precise recommendations on the diet will be given by the attending physician, who is familiar not only with the course of the disease, but also with the general state of the child’s health. For example, if you are allergic to dairy products, you will need to introduce special synthetic drugs and vitamin-mineral complexes instead of dairy dishes.
Leg Exercises
The legs of the "X" in a child at 2 years old already need to be actively corrected, because the degree of curvature increases. You may soon have to apply a plaster cast or otherwise immobilize your limbs. This limits the activity of the child and does not contribute to the timely development. So to carry out exercises to correct the curvature should be approached with responsibility.
To cope with the irregular shape of children's legs will help the simplest set of therapeutic exercises. It is necessary to alternate walking on toes and heels. For convenience, you can mark the child a strip of the required length, for example, from wall to wall in the room. The way in one direction must be overcome on toes, in the other - on the heels. Another exercise is walking, leaning on the inside or outside of the foot in turn.
For the next exercise, you need to take the starting position while sitting on a chair. The child's legs should reach the floor. Alternately, pull your fingers up, and then bend down. Also, feet in turn should be placed on the inside and outside. Duration - about two minutes. You can also perform wiping foot in foot (six to eight times), the foot grabbing various small objects (pebbles, pencils, small soft toys). It is useful to sit on the floor in Turkish, roll the ball and stick with legs, and walk on the log. There are exercises with the Swedish wall: the child must raise and lower the sports equipment barefoot. For safety, adults should be nearby.
Sports loads and physical education
If a child has “X” legs, what should I do? The best medicine for hallux valgus is physical activity, high mobility and athletic activity. The child should run, jump, play outdoor games as much as possible. You can purchase a Swedish wall. It is useful to jump on a large ball, to walk along the ladder lying on the floor. If the child has “X” legs, the treatment is necessarily supplemented by swimming and active games in the water. It is necessary to exclude a long load on the ankle joints and knees, but at the same time ensure the strengthening of muscles and ligaments.
Feet x in a child at 3 years old
The child’s leg deformity should be corrected in three years. If (despite active therapy) the condition does not improve by the age of three, then plaster dressings are applied. This will help to stretch the lateral ligaments, straighten the legs and reduce the pressure exerted on the bone tissue, minimize pressure on the bones, which will allow the knee to form correctly. Wearing a plaster cast can drag on for a long time. The duration of immobilization depends on the severity of the curvature.
The need for surgery
How to fix the legs "X" in a child? According to Komarovsky, surgical intervention with such a pathology is required very rarely (in approximately 7% of cases). Usually resort to surgery in severe cases. The correction method is determined individually. The severity of the pathology and features are taken into account. At the moment, methods of muscle transplantation to the inner edge of the foot, lengthening of the Achilles tendon, and the imposition of an external fixation apparatus for constant wear are most widely used.
The operation to correct the deformation of the legs in children (“X” in the photo below is only one form of deformation that requires correction) is a complex bone reconstruction, which involves intervention on several bones. Walking, fully resting on the leg, is possible only for the third week after the operation. Usually, treatment is considered to be completed at the sixth week after surgery, when a small patient can return to normal life. In general, the recovery period takes two or three months.
Possible complications of deformation
In the absence of adequate therapy, the feet constantly continue to deform, resulting in chronic bursitis. Symptoms of pathology include joint pain, swelling and redness, limitation of mobility, and local temperature increase. Bursitis is accompanied by accumulation of fluid in the joint cavity. In this case, with exacerbation, the joint must be immobilized and kept raised, from time to time apply cold to the sore spot. Reduces the pain of compression with elastic bandages. Treatment of chronic bursitis can be carried out in a hospital.
A complication of deformity can be Deutchlender’s disease (recruits disease). This is a pathological change in bone structure caused by excessive stress. The patient begins to limp, the gait becomes uncertain, the child may stop walking due to pain and discomfort. In the problem area, edema is noted, skin sensitivity, redness increases. The disease is not accompanied by general symptoms: fever, changes in blood structure, and so on, but pain can persist up to several months. Usually the disease ends in complete recovery.
Forecast and Prevention
Feet "X" in children can bend to severe degrees. In this case, the pathology will not only be a pronounced cosmetic defect, but also cause serious impairment of the functions of the limb. A serious consequence of hallux valgus is disability at working age. Mandatory treatment should be carried out in childhood, because after ten years it is almost impossible to fix the legs. In case of slight deformation of the foot and subject to timely therapy, restoration of foot functions is possible.
As for prevention, it begins even during the pregnancy of the mother. The nutrition of a pregnant woman should be varied and useful, it is necessary to take all the vitamins prescribed by the doctor in the exact dosage and according to the scheme. Long walks in the fresh air are very useful for all organs and systems. After the birth of the baby, it is advisable to make every effort to establish breastfeeding and keep it up to a year, but only subject to optimal nutrition of the nursing mother.
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It is often recommended to choose shoes made of high-quality natural materials for the child. But today, many doctors have a different opinion. So that the child does not have “X” legs (Komarovsky fully supports this opinion), one does not need to buy orthopedic shoes as a preventive measure. Moreover, it is better to learn to walk without shoes at all. The human foot is adapted to walk barefoot. Shoes in the current sense, people wear only the last 500 years, no more, and all of Russia until relatively recently walked in bast shoes, in which there were no backdrops. Most Western orthopedists even say that there is no point in using special shoes as a method for correcting hallux valgus.