How to treat children's hallux valgus?

The condition of clubfoot can be discovered after the child is born. This is also called clubfoot in medicine. It may occur in one or both feet. This is caused by the obstruction of the child's ligament development. However, parents do not need to worry too much. Today's medicine is very advanced, and the child's bones and ligaments are very soft, so scientific methods can be used for treatment.

First, treatment methods

This treatment works best when it is started before 9 months of age, preferably soon after birth. For children between 9 and 28 months of age, this treatment is still effective and can correct all or most of the deformity. After 28 months, the Ponseti method is still effective, but most children will need surgery in the meantime.

Summary of treatment methods

1. Manual therapy - After several weeks of manual therapy, the bones of the foot are restored to a nearly normal position, and the foot deformity is gradually corrected.

2. Plaster - After each manual treatment, the foot and calf are cast for 5-7 days to maintain the position of the foot.

3. Repeat steps 1 and 2 until the foot is corrected to the correct position.

4. To completely correct the foot, doctors usually cut the Achilles tendon. This minor surgery is performed under local anesthesia and takes only 10 minutes.

5. Bracing - As soon as the last cast is removed, your child will be fitted with a wearable brace:

a. Wear it for 3 months, 23 hours a day.

b. Wear it every time you sleep for the next 2 to 4 years.

Bracing is a key part of treatment. Even if your child's foot appears to have returned to normal, if they don't wear it every time they sleep, their foot may turn back, even after more than two and a half years of orthotics.

Second, clinical symptoms

1. Unilateral or bilateral foot deformities of varying degrees occur after birth, with the feet showing plantar flexion, inversion, and adduction deformities.

2. When the child learns to walk, he or she walks with the forefoot or the outer edge of the foot. As the child grows older, the deformity becomes more severe. In severe cases, the child walks with the dorsum of the foot on the ground, and bursae and calluses appear in the weight-bearing areas.

3. X-ray film, anteroposterior and lateral view of the affected foot: After birth, the ossification centers of the talus, calcaneus, and cuboid bones can be seen on the X-ray film, and sometimes the third cuneiform bone can be seen. All metatarsal bones and phalanges have appeared, while the ossification center of the tarsonavitoid bone does not appear until the age of 3.

4. Estimation of deformity based on three lines:

(1) Measure the heel-to-heel angle on the AP radiograph. If it is less than 30°, the foot is not inverted.

(2) Measure the angle between the longitudinal axis of the first metatarsal and the longitudinal axis of the talus, which is normally 0°-20°. (3) Measure the angle formed by the longitudinal axis of the talus and the plantar surface of the calcaneus on the lateral X-ray film, which is normally 35°-55°. If it is less than 30°, it indicates foot drop. If the talocereval angle is less than 15° and the angle formed by the intersection of the first metatarsal and the longitudinal axis of the talus is greater than 15°, it indicates talonavicular subluxation (Simon's 15° rule).

Third, diagnosis basis

1. The baby has plantar flexion and varus deformity on one or both sides of the foot after birth.

2. Adduction and inversion of the forefoot, plantar flexion of the talus, inversion and plantar flexion of the calcaneus, contracture of the Achilles tendon and plantar fascia. The forefoot becomes wider, the heel becomes narrower and smaller, and the arch is high. The lateral malleolus is prominent anteriorly, while the medial malleolus is posteriorly and not obvious.

3. When standing and walking, the outer edge of the plantar bears weight. In severe cases, the outer edge of the dorsum of the foot bears weight, causing bursitis and callus in the weight-bearing area.

4. Unilateral deformity will cause limping while bilateral deformity will cause unsteady walking.

5. X-ray: The angle between the longitudinal axis of the talus and the first metatarsal is greater than 15°, and the angle between the plantar surface of the calcaneus and the longitudinal axis of the talus is less than 30°.