valgus deformity – pathology, accompanied by the settlement of the constitution and the kit. inside. In the area of the ankles and feet is caused valgus (X-shaped) deformation of the heel rests on the surface of its inner edge. In a standing position with the feet together, the heel are placed at a distance of 4 cm or more, from each other. The cause for the development of dysplasia of connective tissue, prenatal developmental disturbances of the limbs, and improper shoes in childhood, paresis, paralysis, metabolic and endocrine disorders. Sometimes valgus deformity of the foot is one of the consequences of incorrect posture. The diagnosis put on the basis of the examination, x-rays and podometrii. Treatment in the initial stages of conservative and includes physical therapy and wearing orthopedic shoes. In the marked is not the right place pursuing surgical correction.
valgus deformity – curvature of the axis of the foot in which the middle part of the foot is lowered, the heel takes place outwards, and its inner edge is released, as well. With the patient standing with flattened feet visible X-shaped deformation in the ankle and posterior foot is in contact with the inner ankles and the heel, which is located at a considerable distance from each other. Pathology usually appears in early childhood. Adults can develop as a result of the deterioration of the flat feet, and under the influence of various traumatic and traumatic factors.
Evolutionary due to the shape of the foot provides maximum efficiency in support and movement. The bones of the Tarsus, metatarsus, and toes, which held strong ties, and even a "design" in General, it is moveable, resilient education that provides cushioning during walking and running. Depreciation becomes possible due to the convex foot: longitudinal and transverse. Due to the presence of these archives and the main focus in support of normally distributed between three points: the fifth plyusnevoy bones, the calcaneus and the head of the first bone plyusnevoy.
Congenital or acquired violation of the shape, size or functional ability of the individual elements (bones, muscles, and ligaments) has an impact on all other sections of the foot. The relationship between the anatomical entities, which is broken, a redistribution of the load. In some cases the arch of the foot flattens, leading to the exacerbation of pathological changes. The progression of the flat bones of the metatarsus, and the Tarsus and tibia are increasingly shifted relative to each other, forming a valgus deformity of the foot.
The main reason for the formation of valgus of the feet, as a rule, congenital connective tissue dysplasia. Among the risk factors for injury (foot fractures, breaks and tears of ligaments), osteoporosis, endocrine diseases (diabetes, thyroid disease), and excessive load on the foot due to the extra weight. valgus of the foot can also be one of the manifestations of the disorders of posture. In some cases (for congenital anomalies) deformation of the foot was detected immediately after birth, but is more often happens when the child begins to walk and is exacerbated by wearing inappropriate shoes, lack of physical activity or not properly selected physical activities. The development of valgus feet at the age, usually occurs during pregnancy or sudden weight gain, on the basis of the existing flat feet. Paralysis and skeletal injuries of the foot, valgus deformity may be created without the prior flat feet.
Depending on the reasons for the development of experts in the field of Orthopaedics and traumatology, there are the following types of valgus stop:
Taking into account the severity, there are three levels of valgus stop:
The patient who suffers from pain after walking or static loads, especially pronounced when using the wrong shoes. Also possible tension, pain in the calf muscles and gait disturbance. In severe cases, the pain syndrome it becomes almost constant. The external examination showed that the number of typical changes: the patient rests on the floor of the outer edge of the foot, the entire surface is detected by the flexion of the anterior towards the posterior. Below the inner ankle is defined by a protrusion, which is formed due to the shift of the head tarannoy bones. In some cases, by this protrusion, is another horn lad yevidnoy bones. Front allocated towards the rear. The longitudinal axis of the foot is bent. Rejected heel outwards and resting on the ground, not the middle part and the inner edge. The outer ankle is smoothed, the internal acts.
With the patient standing heel, which is located at a distance from each other. Plumb Bob, which descends from the middle part of the ikronozhnoy the muscles that are located inside from the heel. Palpation revealed tender points on the inner edge of the podoshvennogo aponevroza, under the lad yevidnoy bone and just above the top of the outer ankle. Often, it is also noted diffuse tenderness of leg muscles, especially pronounced on the rear surface of the leg above the heel, on the inner surface of the leg and in the region of the front crest of the tibia. Pain in the muscles due to the increased load and a constant voltage due to disturbances in the normal function of the foot.
Pathology usually occurs in childhood. In the absence of treatment or improper treatment, deformity persist throughout life, however, before the emergence of functional disturbances in the patients do not seek treatment. Recurrence can develop at any age. Adolescents and young people, together with the appearance of pain, possible worsening valgus deformity. Patients, the elderly and advanced age morphological changes, typically not progressive, the prevailing functional disorders. Pain with valgus deformity of the foot in adulthood often appears on the back of increased workloads and changes in the General condition of the body: in the last months of pregnancy, during quick weight gain, klimaktericheskom period, and after a long inactivity due to a change in living conditions or serious illnesses.
The diagnosis is exposed on the basis of the external characters of and data of instrumental studies. On external examination, the doctor pointed to the flattening in the arches of the foot, the protrusion of the inner and smooth outer ankle, as well as the deviation heels outwards. To confirm the diagnosis and determine the degree of deformation is carried out plantografiya, x-rays of the feet and podometriya. On rentgenogrammy showed that the reduction in the height of the arch of the foot, disruption of the location of the front, middle and rear parts of the foot and separate the bones in the joints of the Tarsus. Podometriya used to estimate the load distribution on the foot. Computer plantografiya used to calculate the angles, parameters and indices, which allows to determine the presence and type of flat feet.
Patients with spasticheskoy and paraliticheskoy deformation in for a consultation with a neurologist or neuro-surgeon. If you suspect a disease of the endocrine system of statutory consultation with the endocrinologist. If you suspect that osteoporosis is necessary densitometry, dual rentgenograficheskaya absorbtsiometriya or photonic absorbtsiometriya. If the cause of osteoporosis is menopause, the patient is shown the consultation with the gynecologist.
Treatment is provided by orthopedic surgeons or traumatologists. When the valgus deformation of foot in children is a successful conservative treatment, including wearing orthopedic shoes, massage, ozokerite, paraffin, mud, magneto therapy, diadinamoterapiyu, electrophoresis and physical therapy. Surgical intervention is only rarely necessary and usually take place in the congenital vertical arrangements tarannoy bone or Achilles tendon. In addition, when the vertical tarane uses a combined methodology Dobbs: for the first time, the foot is withdrawn into the correct position using a plaster bandage, and then fix taranno-lad evidnyj common with the help of the spokes of Kirchner and perform a full through the skin akhillotomiyu. Then put in a cast for 8 weeks, after which prescribed the wearing of breysov, and then orthopedic shoes.
The possibility of conservative treatment of adult patients is limited, in severe valgus foot surgery is required. Depending on the type and degree of flat foot can be performed resection taranno-calcaneal joint, artrodez taranno-calcaneal joint, transplant tendon of the long peroneal muscle and other artroplasticheskie operation.