Valgus deformity of the knee in children: treatment, causes

Valgus deformity of the knee – a change to its knees, distorting the shape of the legs and giving them the form of the letter H. the Disease is also characterized by investment and internal hip rotation and deviation of the tibia outwards.

Valgus knees are a common pathology, which affects especially children and the elderly. Valgus deformity of the knee joints in children can be cured completely with conservative methods.

Characteristics of the disease

Lateral curvature of the lower extremities is characterized by the formation of the open outer angle between the femur and the tibia, as the internal condyles of the hips developing faster external. The inside of the slit of the joint extends, and the rest of the constriction. The process consists of the ligaments that supports the joint. The ligaments that stretches from the inside, and walking man forced to pull down.

Pathological curvature of the legs is considered in the case of which the space between the interior surfaces of the ankles and right, strongly pressed to each of the knees is more than 5 cm it Should be noted that for some babies valgus curvature is normal until a certain age. A temporary default because of the lateroposition (outward deviation) of the muscle quadriceps and it is not dangerous.

In extremely rare cases, a child that was born with a deformity of her knees. If this happens, there is also the curvature of the neck femoral, valgus installation of the tibia, and flat feet.

Children's valgus knees is unilateral and bilateral. In the first case, deformation of the limbs, and in the second both. A slight curvature in the newborn is often a physiological norm, and as a child gets older, the legs should be straightened. However, to control the process, it is necessary not to lose the progression of the disease.

If the deformation does not happen, you should immediately take action against the ligaments and muscles of the child is in the early stages. The disease develops especially quickly from the moment the baby starts to walk. The lower limbs are subjected to serious strain, and muscle structure can handle.

Valgus defect necessarily need to be treated, because otherwise it will suffer the whole locomotor system.

Reasons

Deformation of the knee joints can cause the following conditions:

  • high load on the legs during periods of rapid growth when muscles and ligaments are still little developed;
  • rickets, lack of vitamin D and calcium;
  • disease Erlacher-Blount (deforming osteochondrosis of the tibia);
  • the paralysis of the extremities;
  • damage to the bones of the pelvis;
  • excess weight;
  • wearing shoes uncomfortable – too narrow or, conversely, a wide;
  • the injury and inflammation of the joints;
  • ecological factor.
valgus-knee -

The main and most common deformities of the foot are overloading the limbs, when the child begins to take their first steps. In the process of growth of the shape and relative position of the bones that form the knee joint, is changing. Children tend only to bend your knees, and walk fully straighten the joints. Instinctively babe puts legs wide, as the muscles are weak. Because of this, varus (Or shape) set of feet gradually, over the course of several years, changing into valgus. At the age of 5, 6 or 7 years, everything returns to normal, and in the case of the rest of the deformation is talking about the pathology.

Symptoms

To determine the valgus deformity of the knees in children and adults is possible in accordance with the following criteria:

  • the knees and feet outward, when it can develop flat feet;
  • during walking or standing caused by tiredness and the discomfort and the pain;
  • with the defeat of a tribe can develop scoliosis;
  • due to the deformation of the legs-up changes, becomes soft;
  • to congenital forms of valgus is characterized by the curvature of the femoral head.

There are 3 degrees of hallux valgus:

  • elementary: deviation tibia outwards, is not more than 15°;
  • second: the Shin was reduced by more than 15°;
  • third: this stage is characterized by the deviation of the tibia in the direction of more than 20°.

Treatment

Treatment of valgus deformity of the knee in children is complex and must be based on the diagnostic studies. To clarify the severity of the disease to make the radiograph. To exclude joint diseases evaluate indicators of biochemical analysis of blood: presence of C-reactive protein, factor rheumatoid and uric acid. With the help of the tests on minerals to determine the level of calcium and phosphorus in the body.

The modern methods of treatment allow to completely fix the form of the legs and stop further progression of the deformity. Apply several effective ways:

  • wearing orthoses;
  • physiotherapy;
  • massage;
  • LFK.
valgus-deformity-of-children

Orthopedic devices and physiotherapy

When hallux valgus apply spell style and the tyres, the fixation of the knee joint. These products are prescribed by a doctor-orthopedist, that in the course of the treatment process regulates the required level of fixation. It should be borne in mind that the use of these devices can not be, in violation of the circulation of the lower extremities.

To strengthen and improve the contractility of the muscles of the leg as prescribe physiotherapeutic procedures such as electrical stimulation.

To influence the body with pulses of electric current are achieved the following results:

  • increases the volume and strength of muscles, maintaining the length of the muscle fibres;
  • increase the capacity of adaptive and the limit of muscular fatigue;
  • decreases the pain syndrome;
  • always with good drainage and the rapid removal of metabolites,
  • restores the nervous system regulation of muscle contraction;
  • because of the alternation of contraction and relaxation to prevent muscle atrophy.

After the course of several treatments of electrical stimulation of the muscles to be more stringent and it is easier to maintain the correct position of the feet when walking or standing. Before assigning the electrical stimulation, the doctor takes into account the following contraindications:

  • the tendency to bleeding;
  • thrombophlebitis;
  • acute inflammatory and infectious processes in the body.

Massage

The stability of the joint that allows the muscles massage, as diverse groups of muscles of the back, buttocks, thighs, and shins. The course of treatment consists of 10-20 sessions, between the courses are of two weeks or a month of rest. The intensity of the impact increases after a couple of treatments, the sharp and rough movements are unacceptable.

massage

The massage is done like this:

  • The patient is in the abdomen, under the leg to put the roller.
  • Massage on the lumbar region down and to the sides of the spine. Followed by rubbing, kneading and pressing.
  • Sacral region massage movements in a circle or in an X-shaped direction, then is pounded intensely the outer surface of the bent fingers. Next, one or two hands to produce kneading. The final stage – percussion techniques: cut movement, as well as blows, slaps.
  • Massage back of the thigh start doing in the direction of knee up and out, and then rubbing, kneading and effleurage movements of the fingers of the hands.
  • Bottom of the leg massage by stroking in the direction from the heel up to the knee joint. Special attention is given to the external and internal sides of the tibia: the outer part is massaged gently, with a minimum of pressure, with a vibration and stretching techniques. At the end of the session, and petting. Massage of the internal surface is intense, with the use of light percussion techniques.
  • The knee joint is adjusted stroking and rubbing the side surfaces, the pressure on the internal face of the whole of the region of the condyle femoral. At the time of making your hand free to hold the tibia in the lower part, try to bring it as close as possible to the middle line.
  • Achilles tendon and making massage movements.
  • The patient rolls on his back, put a pillow under your knees.
  • Massage the front of legs start to stop: strokes from the toes to the calf massage on the back of the surface. Followed by intense rubbing and kneading the inner part of the ankle and foot. In the final strokes.
  • In a circular motion started to caress her knee and rubbed the face of the surface. Then produce a pressure on the inner part of the joint simultaneously bring the shins to the middle line.
  • Anterior surface of the legs are massage with light sweeping movements in the upward direction.
  • Returning to her thighs, caressing and doing the average of the intensity of friction and kneading. At the end, stroking the leg from the knee up and towards the outside of the legs.

Physiotherapy

To correct for the distortion that it requires time and effort. Exercise regularly at least 2 times a day, a focus should be after a massage.

Exercise 1. Flexion and extension of the ankle.

Exercise 2. The rotation of the feet alternately in one and other party. To perform the movement you need gently and to make sure that there was no pain.

Exercise 3. The seizure and retention of items feet.

Exercise 4. Initial position – posture in Turkish. From this position, you must stand up, relying only on the external part of the foot. If not, you can ask someone to exercise with support. Then, sit in a posture with a Turkish bath, and change the legs so that the top was the other leg. Repeat the exercise.

Exercise 5. Squat, spread wide on her knees to part. An important condition is the correct position of the stop must be completely on the ground and be parallel to the other.

Exercise 6. Rise on your toes and stretch whole body upward. Then down fully on the foot.

Exercise 7. Walk to the outside of the feet.

Exercise 8. Walking along a narrow Board with a width of 10-15 cm, instead of the Board of directors can be guided by a painted stripe or a carpet of color on the carpet. The foot should be put as close as possible to the other.

photo strain

Surgical treatment

In advanced stages or with the complications valgus to correct the deformity through surgery. As a general rule, the operation is assigned to patients of advanced age, since the disease often occurs in severe form. The indication for surgery is also related to the deformation of the meniscus of the knee, in the care that conservative methods do not work.

Before the operation is performed a series of diagnostic procedures through magnetic resonance imaging and computed tomography.

The essence of the operation – the creation of artificial fractures with subsequent correction of the foot with the Ilizarov fixator.

The rehabilitation of the limb operated on is anesthetized and walk use special tools. In the future, patients that are transferred with the help of crutches. The Ilizarov apparatus allows the correction of the limbs and after the surgery – 8 or 9 days.

Surgical treatment is also used in case of failure of conservative methods. Then, a wedge-shaped area of the tibia is to remove it surgically, and then the bone grows. Children under 16 years of deformed limbs immediately leads to anatomically correct position.

To restore the function of the feet, prescribe the complex of exercises therapeutic. The exercises necessary to build strong muscles, able to keep the knee in physiological state.

After the surgery the patient is in the process of rehabilitation, which, in addition to therapeutic exercises, including physiotherapy and massage.

It is worth noting that just started the treatment gives you the opportunity to make a prediction optimistic, even with advanced forms of valgus, and regardless of the age of the child. Implementation of medical recommendations, you can avoid this type of complications such as osteoarthritis, damaged meniscus and the anterior cruciate ligament. In addition, it also excludes the fatigue and trauma of the lower limbs, leg pain and back problems. To consolidate the success of the treatment will help in the use of shoes orthopedic, the blockade of the ankle.

15.08.2018