Valgus deformation: What is it?

Valgus deformation of the steps is most often congenital. In some cases, however - with paralysis, traumatic lesions - can occur in the mature period of life. The main symptoms of the pathology are soreness in the area of the legs and muscles of the lower leg, a visible disorder of the shape of the legs, and a change in gait. The diagnosis of the disease is carried out using a clinical examination, X -treatment, electromyography, etc. Treatment includes conservative and surgical methods. However, proper efficiency is observed only in reconstructive operations.What is this disease?curvature

Valgus deformation is the curvature of the foot characterized by the equalization of its longitudinal arch. Usually the inner edge of the foot is descended ("drops") and the heel turns out.

The step of a person, by virtue of his location, acquires the pressure of the entire mass of the human body. For this reason, it has a special anatomical structure that allows depreciation, balancing and stabilizing movements. However, an important component for performing these tasks is the correct form of stopping.

Today, the most important problem of traumatology and orthopedics is the deformation of valgus on the foot. The meeting is estimated at 30-58%, where 2/3 of cases make up congenital disorders.

The pathology is largely socially significant as it covers all age groups of the population and also helps to curl the spine, the early development of osteochondrosis and arthrosis of the joints of the lower limbs.

When you take your feet (if you look at them from the back), a deformation of X is formed at the level of the ankle: the ankles are in contact while the heels are 5-6 centimeters apart.

Most often, the pathology is congenital by nature and is diagnosed in children back to the hospital (or immediately after the start of walking). Such a condition is regulated for up to 5 years, after which (in the absence of proper treatment), the child develops flat legs.Why does it occur?

It is believed that the main cause of valgus deformation of the foot is an inadequate function of the posterior tibial muscle or weakness of the ligamental apparatus.

Today, other factors are distinguished in the development of pathology:

  • Congenital anomalies with improper location of the bones of the legs or shortening of the tendons (vertical memorial bone, short tendon on a heap);
  • Foot deformity disorders compensate for the curvature of the spine;
  • Traumatic lesions (bone fractures of the legs, lower legs, thighs or knee, ruptures of the ligamentary and tendon apparatus);
  • Paralysis (immobilization) due to damage to the nervous system for encephalitis, polio, stroke, disruption of cerebrospinal hernia me notes, etc. ;
  • Spasm (constant contraction) of the muscles of the lower leg;
  • Concomitant diseases: pathology of the bone system with vitamin D (rickets), diabetes mellitus, osteoporosis (decrease in bone density), impaired thyroid gland and parathyroid glands, etc. ;
  • Increased body weight, including rapid weight gain in menopause or during pregnancy.Types of deformation

    The development of the pathology is also facilitated by improperly selected shoes or excessive correction of the club in childhood.Degree and stage of disease

    The severity of pathology (the power of manifestation) is divided into degrees:

  • Light with a vault height of 1, 5-2 centimeters and an angle of inclination of the heel to 15 degrees;
  • The average when the arch is flattened to 1 centimeter, and the angle decreases to 10 degrees;
  • Heavy at the height of the vault up to 0, 5 cm, and the heel inclination angle is 5 degrees.

    Depending on the participation of certain structures, the following stages of curvature are distinguished:

  • There are no bone deformities, the pain is determined on the inner surface of the ankle (in the area of attachment of the posterior tibial muscle);
  • The curvature is light, the heel is slightly rejected;
  • The leg is distributed and the deformation is fixed (not properly adjusted);
  • Inhalation is observed not only in the foot but also in the ankle joint.Symptoms

    In the first stage, patients are disturbed by periodic pain after prolonged walks or long vertical loads (standing or sitting on the foot). As a rule, pain syndrome is enhanced when walking in improperly selected shoes. The next stage of the disease is related to the appearance of the curvature of the foot: patients in the standing position do not rely on the outer edge of the foot, but with its entire area. There is a slight change in gait. Deformation

    In the third stage, the protruding of the thawed bone is determined (noticeably the lower ankle on the inner surface of the ankle), as well as a strong deviation of the heel outside (the patient is based on the inner edge of the heel bone). The advanced deformation of Valgus of the feet is characterized by a pronounced curvature of both the leg itself and the ankle joint. Patients complain of severe pain in the lower leg muscles, as well as a significant impairment of the gait: the knees rub against each other until the right and left legs are located at some distance.

    The severe curvature of the steps is often complicated by deformity of the spine (scoliosis with different positions of the shoulders and wings of the pelvis), osteochondrosis (damage to the intervertebral disc with hernia formation) or arthrosis (premature wear of the intraaric carpet.How to diagnose?

    The diagnosis of the curvature of the foot consists of:

  • The clinical examination during which the orthopedist detects a decrease in the arches of the foot, the deviation of the bones of the heel and the ram, the visible "disappearance" of the outer and convexity of the inner ankles.
  • X -ray - an affordable and informative method that can determine the change in the bone slope angles and linear parameters of their connection. These indicators are required to make a final diagnosis and clarify the degree of deformation.
  • The method of registering steps aimed at determining the exact functional status of the limb. The method is to register the time of support of the individual parts of the foot when performing a step. In the course of the study, the phases of the rolling of the foot are also studied, which reflect the balance of the muscles of the lower limb.
  • Dynamic electromyography that records the electrical activity of the examined muscles and its dependence on the phase of the step.
  • Photoplelesmography with digital processing that allows you to get all the standard indicators and determine the type/degree of curvature with high accuracy.

    Additional consultation of a neurologist (with deformities due to cramps or paralysis), endocrinologist (in case of diabetes or thyroid disorders/parathyroid gland) and gynecologist (when the threat) may be required. If the curvature of the foot appears against the background of osteoporosis, densitometry is required - bone density examination.Curvature chainTreatment

    Among the main methods of treating Valgus curvature of the legs are conservative and surgically. Do not destroy sore joints with ointments and injections!

    Conservative approach

    This type of help is aimed at getting rid of the symptoms of the disease, but does not eliminate the root cause of the pathology.

    The technique includes:

  • the use of orthopedic bone support insoles I plus, the arch of the foot, as well as the elimination of valgus lesions of the middle and back of the foot;
  • Record - fixing the foot and ankle with the help of special adhesive ribbons with appropriate elasticity. The strap is worn around the clock within 3-5 days, after which they are replaced;
  • sewing orthopedic shoes to individual standards;
  • The use of orthosis and other fixing devices of the foot and ankle.

    Conservative methods also include physiotherapy procedures (ozocket, paraffin applications, electrophoresis, magnetic effects), massage and a complex of physiotherapy exercises designed for a specific clinical case. Watch out! Today, most experts prefer surgical treatments because conservative therapy is ineffective (according to statistics, it is useless in 60% of cases).

    Surgery

     The volume of work and its type depend on the direct stage of the disease. Thus, the first degree of deformation of Valgus is treated by synavectomy (removal of the tendonal sheath for adjusting the total tension) or osteotomy (dissection) of the heel to return to the anatomically correct position. In the second stage of the development of the disease, a transplantation of the tendon turns of the fingers is used. Such intervention is usually performed against the background of dissection of the heel or arthrodesis with an ram with ram (surgical immobilization of the joint between RAM and scaphoid bones).

    Grade III curvature requires arthrodesis of several joints on the foot at a time: a hassle -free, five cup of cubes and decisive RAM. Such a three -dimension of immobilization is often supplemented by dissecting the bone of the heel. In the IV stage of the pathology, reconstructive operations are needed not only on the foot but also on the ankle. In this case, the instability of the ligamental apparatus is regulated by transplants (from their own body or artificial materials). The volume of operations on the leg itself is the same as at the III degree of curvature.

     Recovery period

    Rehabilitation involves walking without maintenance of the operated leg for 2 months. At the same time, the patient should wear a movable plaster for a long spill of 1, 5 to 3 months. Active movements in the working leg are recommended to start 1, 5 months after surgery. By the 3rd month, a complex of strengthening physical education is introduced. Subsequently, however, patients are forbidden not to be unequal walking and active sports activities. It is worth noting that it is possible to assess the end result of the operation only six months later.Preventive measurestreatment

    Prevent Valgus deformation of the stop includes the following measures:

  • Early correction of congenital anomalies with the incorrect arrangement of the bones of the legs or shortening of the tendon beans (vertical thawed bone, tendon of short heels);
  • Correction of posture disorders (scoliosis, etc. );
  • Timely treatment of traumatic lesions (bone fractures of the legs, lower legs, thigh or knee joint, tears of the ligament and tendonal apparatus);
  • Proper rehabilitation after paralysis (immobilization) due to damage to the nervous system for encephalitis, polio, stroke, disruption of cerebrospinal roots for hernia, etc. ;
  • Relief of spasm (constant decrease) of the muscles of the lower legs;
  • Concomitant disease therapy: pathologies of the bone system with vitamin D (rickets), diabetes mellitus, osteoporosis (decrease in bone density), impaired thyroid function and parathyroid glands, etc. ;
  • Reducing body weight to normal (especially with rapid weight gain in postmenopause or due to pregnancy);
  • Choosing orthopedic shoes or use of souvenators;
  • Moderate Clubfoot correction without "hyper-correction"-expansion treatment that leads to secondary valgus-exclusion of the legs.

    Preventing the progression of the disease is to use conservative methods and early reconstructive operations. In this case, physical activity is limited to prevent the destruction and curvature of the ankle joints. Remember that timely treatment of valgus deformation of the feet not only improves the quality of life of patients, but also prevents the development of osteochondrosis and arthrosis of the knee or hip joint!