Valgus deformity of the knee in children: treatment, causes

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

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

Features of the disease

Lateral curvature of the lower extremities is characterized by the formation of the open outer angle between the femur and tibia, as the internal condyles of the hips developing faster external. The inner slit of the joint extends, and the outer constricting. The process involves the ligaments that supports the joint. Ligaments are stretched from the inside, and walking man forced to stretch down.

Pathological curvature of the legs is considered in the case when the space between the inner surfaces of the ankles straightened and tightly pressed to each other's knees is more than 5 cm it Should be noted that for some newborns valgus curvature is normal until a certain age. A temporary defect due to the lateroposition (outward deviation) of the quadriceps muscle and is not dangerous.

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

Children's valgus knees is unilateral and bilateral. In the first case one deformed limb, and in the second both. A slight curvature in newborns is often a physiological norm, and as a child gets older, the legs are straightened. However, to control the process, it is necessary not to miss the progression of the disease.

If the deformation does not pass, you must immediately take action before the ligaments and muscles of the child are in the formative stages. The disease develops especially quickly from the moment the baby begins to walk. The lower limbs are subjected to severe strain, and muscle structure can handle.

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

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 poorly developed;
  • rickets, lack of vitamin D and calcium;
  • disease Erlacher-Blount (deforming osteochondrosis of the tibia);
  • paralysis of the limbs;
  • damage to bones of pelvis;
  • overweight;
  • wearing uncomfortable shoes – too narrow or, conversely, a wide;
  • injury and inflammation of the joints;
  • ecological factor.
valgus-knee -

The main and most common cause deformation of the foot are overloading the limbs, when the child begins to take the first steps. In the process of growth form and relative position of the bones forming the knee joint, is changing. Very young children tend only to bend your knees, and walking fully straighten the joints. Instinctively babe puts legs wide, as the muscles are weak. Because of this, varus (O-shaped) set of feet gradually, over several years, changing into valgus. At the age of 5, 6 or 7 years everything comes back to normal, and in the case of the remaining deformation is talking about pathology.

Symptoms

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

  • knees and feet outward, when it can develop flat feet;
  • during walking or standing caused by fatigue and discomfort and pain;
  • with the defeat of one tribe may develop scoliosis;
  • due to the deformation of the legs gait changes – it becomes smooth;
  • for 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 declined 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 upon the diagnostic studies. To clarify the severity of the disease make the radiograph. To exclude articular pathologies evaluate indicators of biochemical analysis of blood: presence of C-reactive protein, rheumatoid factor and uric acid. With the help of tests on minerals to determine the level of calcium and phosphorus in the body.

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

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

Orthopedic devices and physiotherapy

When hallux valgus apply corrective styling and tires, fixing the knee joint. These products are prescribed by a doctor-orthopedist, who in the course of the treatment process regulates the required level of fixation. It should be borne in mind that wearing these devices can not be in violation of the circulation of the lower limbs.

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

By influencing the body with pulses of electric current are achieved the following results:

  • increases volume and strength of muscles while maintaining length of muscle fibers;
  • increase adaptive capacity and limit fatigue muscle;
  • decreases pain syndrome;
  • provided with good drainage and rapid removal of metabolites,
  • restores the nervous regulation of muscle contraction;
  • due to the alternating contraction and relaxation prevented muscle atrophy.

After the course of several treatments of electrical stimulation of muscles become tighter and it is easier to maintain the correct position of the feet when walking or standing. Before you can assign electrical stimulation, the doctor takes into account the following contraindications:

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

Massage

The stability of the joint allows the muscles massaged so several groups of muscles of the back, buttocks, thighs and shins. The treatment course consists of 10-20 sessions, between courses are two-week or month breaks. The intensity of the impact increases after a few treatments, the sharp and rough movements are unacceptable.

massage

The massage is performed like this:

  • The patient lies on the abdomen, under the lower leg put the roller.
  • Massage the lumbar region downward 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 produce kneading. The final stage – percussion techniques: chopping movement, as well as beating and slapping.
  • Massage back of the thigh begins stroking in the direction from the knee upwards and outwards, and then rubbing, kneading and effleurage movements of the fingers.
  • Lower leg massaged 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 minimal pressure, using a vibrating and stretching techniques. At the end of the session and the stroking. Massage the inner surface is intense, with the use of light percussion techniques.
  • The knee joint is adjusted by stroking and rubbing the side surfaces, the pressure on the inner side of the joint in the region of the femoral condyle. At the time of pressing your free hand to hold the tibia in the lower part, trying to bring her as close as possible to the middle line.
  • Achilles tendon and stroking massage movements.
  • The patient rolls on his back, put a cushion under your knees.
  • Massage the front of legs start to stop: strokes from the toes to the calf massaged the back surface. Followed by intense rubbing and kneading the inner part of the ankle and foot. In the end – stroking.
  • In a circular motion started to caress his knee and rubbed the side of the surface. Then produce a pressure on the inner part of the joint simultaneously bringing the shins to the midline.
  • Anterior surface of lower legs are massaged with light rubbing movements in the upward direction.
  • Turning to the thighs, stroking and doing medium-intensity rubbing and kneading. In the end stroking the leg from the knee up and towards the outside of the legs.

Physiotherapy

To correct the deformation that is required long and hard work. Exercise regularly at least 2 times a day, one approach should be after a massage.

Exercise 1. Flexion and extension of the ankle joints.

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 pain.

Exercise 3. The seizure and retention of items feet.

Exercise 4. Starting position – posture in Turkish. From this position, you need to get up, relying only on the external part of the feet. If not, you can ask someone to exercise with support. Then sit in a pose with Turkish and switch legs so that the top was the other leg. To repeat the exercise.

Exercise 5. Squat, wide spreading knees apart. An important condition is the correct position of the stop: they need to be completely on the floor and be parallel to each other.

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

Exercise 7. Walking on the outer part of the feet.

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

photo strain

Surgical treatment

In advanced stages or with existing complications valgus deformity corrected by surgery. As a rule, the operation is assigned to older patients, as their disease often occurs in severe form. The indication for surgery is also related deformation of the meniscus of the knee, to cure which conservative methods don't work.

Before the operation is performed a number of diagnostic procedures using magnetic resonance and computer tomography.

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

Rehabilitation of the operated limb of anesthetized and walking use the special tools. In the future, patients are moved with the aid of crutches. The Ilizarov apparatus allows to perform correction of the limbs and after surgery – on the 8th or 9th day.

Surgical treatment is also used in case of failure of conservative methods. Then a wedge-shaped area of the tibia is removed 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 complexes of therapeutic exercises. The exercises necessary to build strong muscles, able to hold the knee in physiological state.

After surgery the patient is undergoing rehabilitation, which, in addition to therapeutic exercises, includes physiotherapy and massage.

It is worth noting that just started treatment gives you the opportunity to make an optimistic prognosis even with advanced forms of valgus, and regardless of the age of the child. Performing medical recommendations, you can avoid such complications like osteoarthritis, damaged meniscus and the anterior cruciate ligament. Further, it also excludes fatigue and trauma of the lower limbs, leg pain and back problems. To consolidate the successful outcome of the treatment will help the wearing of orthopedic shoes, locking ankle.

15.08.2018