Why do foot problems occur in children of different ages. Doctor Komarovsky about hallux valgus and flat feet Orthopedic foot problems in children

Any parents from the very birth of the baby are worried about the condition of his legs, will they be crooked, is everything in order with the feet, and will the baby walk well? If it seems to parents that not everything is in order with the baby’s feet, they begin to worry a lot, because the health of the entire skeleton, especially the spine, the beauty of posture and the ability to actively move, largely depend on the health of the foot. Often parents compare the gait and legs of babies with adults, and it seems to them that the child has problems with feet and gait, and sometimes, on the contrary, parents prefer not to notice that the child walks somehow incorrectly, attributing it to age characteristics and leg formation. How right, where is the line between the norm and pathology when assessing gait, setting the feet and resolving the issue of foot deformities? Today we will talk about such a problem as flat-valgus feet in babies.

What is flat-valgus feet?

A valgus deformity of the foot is called such a condition when the leg is, as it were, littered inward, and if the child’s knees are tightly compressed and straightened, a distance of more than four to five centimeters appears between the inner surfaces of the ankles. With this position of the legs, the toes and heel deviate towards the outer edge of the foot, and the inner arch of the foot, as it were, collapses inward. As a result of valgus deformity of the foot, the legs acquire an X-shape, the knees sharply converge with each other by the inner edges. If valgus deformities of the foot are also accompanied by a decrease in the height of the arch of the foot, then we are talking about flat-valgus deformity of the feet in babies. It is these anomalies in the development of the feet that are found in pediatric orthopedics and traumatology.

According to statistics, almost every second of children under five years of age who gets an appointment with an orthopedist and has deviations in the development of the feet is diagnosed with plano-valgus deformity of the foot. At the same time, violations are accompanied by the following manifestations - a flattening of the longitudinal arch of the baby's leg occurs, a valgus position is formed in the posterior section, while the forefoot assumes an abduction-pronation position. Simply put, the foot becomes flat, the foot falls inward, while the toes deviate to the side, which gives a specific look to the legs and gait of the baby. Most often, such an anomaly occurs in preschool or at primary school age, although sometimes the diagnosis is made illegally when there are no problems.

Why is the shape of the foot so important?

The special shape of the human foot was formed by centuries of evolution precisely in order to maintain it in an upright position, while distributing the load on the body, given that the weight of the human head is much larger in comparison with all other living beings. The bones of the foot are numerous, they are interconnected by interosseous and very strong ligaments, which forms a fairly elastic and mobile arch of the foot, the role of which is to maintain the maximum possible depreciation during movements - running, jumping, walking. The feet act as biological springs, preventing the body from shaking violently. The convex arch of the foot has an orientation in two directions at once - in the longitudinal and in the transverse. Due to this, the normal foot of an adult has three points of support on the foot - in the area of the head of the first metatarsal bone (under the thumb), in the heel area and in the area of \u200b\u200bthe fifth metatarsal bone (under the little finger).

In children, the arch of the foot at birth does not look like an adult, their feet are flat, without arches and bulges, and when the child takes his first steps, his feet are still quite flattened, so the child’s gait is uncertain and it is difficult to keep balance. During the first steps, a rather large load falls on the baby's feet, which later allows the child to learn to walk and form a normal arch of the foot. Parents should remember that there is no need to panic because the child’s gait in the first years of his life is not ideal - his foot is still growing and forming, and it is impossible to draw conclusions that “we have flat feet” or “we have clubfoot”. This is incorrect from the point of view of age anatomy. A confident gait and the correct arch of the foot will be formed in the child gradually, you do not need to immediately put an end to the child in terms of his further possibilities or run to the store for corrective shoes.

Usually, parents' complaints that something is wrong with the child's legs arise from the very first attempts of the child to walk. But at this age, it is necessary to clearly distinguish such a phenomenon as the physiological flattening of the arch zone of the foot, especially if it is a baby under three years old, the development of already flat-valgus beveling of the foot, which will require observation and correction by an orthopedic doctor. Until the age of about three years, there are special fat pads on the area of \u200b\u200bthe child’s feet, and therefore, if you look at the baby’s foot, its arches will not be very visible. The arch of the foot will be contoured if you ask the baby to stand on his toes. Bone tissues in the foot area will form in a child until about five or six years old, and therefore only at this age does it make sense to talk about whether or not a child has a deformity of the foot, especially its plano-valgus form.

However, it is worth noting that there are congenital anomalies of the feet with a strong plano-valgus deviation, and then the diagnosis of valgus feet is made from the maternity hospital, there is a vertical ram, an anomaly of intrauterine development of the foot. But these anomalies of the foot are visible to the naked eye and they are present immediately from the very beginning. Why are flat-valgus feet bad, except for a directly cosmetic defect? First of all, they lead to a negative effect on the spine and its curvature, constant pain in the legs and the formation of early osteochondrosis and arthrosis in the affected joints. This significantly limits the quality of life of such children and their choice of profession in the future.

The reasons for such an anomaly of the feet

The valgus form of foot deformity can be congenital or acquired in a child. In the congenital form, the leading factors are usually unfavorable factors that affect the development of the shape and position of the bones in the top, and then valgus-type foot deformities can be diagnosed either immediately at birth or in the very first months of the baby's life. The most severe and related to true congenital forms can be considered the foot "vertical ram" and "rocking foot". The acquisition of the form of a valgus foot in childhood is associated with the imperfection of the ligamentous and tendon apparatus, deviations in the formation of the baby's musculoskeletal system. Usually, these deviations begin to be detected in children not earlier than a year, when children make attempts to walk independently without support.

Valgus deformities of the feet are usually formed in debilitated children with diffuse muscular hypotension. The reasons for such hypotension can be the prematurity of the baby or the transferred intrauterine malnutrition, hypoxia, and it can also be the result of congenital weakness of the connective tissues, with frequent diseases at an early age, especially if they were SARS, pneumonia and bronchitis. A special role in the weakening of the musculoskeletal and ligamentous apparatus is assigned to such a disease of children as rickets. Also, a violation in the dynamic and static relations of muscles and ligaments occurs with such pathologies of neuromuscular transmission as polyneuropathy, cerebral palsy, poliomyelitis and myodystrophy. Hallux valgus in toddlers at an early age can be the result of overweight and obesity, which leads to pathological stress on the foot due to body weight.

In some cases, valgus deformities in the foot area in babies can be the result of injuries to the muscles, ligaments or bones in the lower leg and foot area, prolonged immobilization of the leg with a cast or bandage. Even less often, such valgus deformities occur in children with dysplasia and congenital dislocation of the hip. And yet - and all parents need to pay attention to this, the causes of valgus deformity of the feet in babies may be the early onset of walking, when parents put children on their legs at almost 5-6 months and lead them by the handles, imitating what the child supposedly wants walk! Too soft and poor-quality shoes for the first steps can also affect the formation of a valgus foot.

If the child’s muscle tone is weakened, and at the same time he is also put on legs and forced to walk, under the weight of his own weight, the arches of the foot flatten and weak ligaments are greatly stretched, the foot remembers such a pathological position, the ligaments of the tibial muscles are weakened, the ligaments in the area of the fingers are weakened on the foot. And after such forced loads, the foot can no longer be formed correctly. Think about this before you put the child on his feet and lead him by the handles and allegedly "walk". With hallux valgus, the foot in children shifts inward, towards the ankle joint, while the heel and fingers turn outward.

The health of a baby is the most valuable thing in a parent's life. Unfortunately, sometimes an orthopedic doctor diagnoses abnormalities that can be treated with an immediate response. Among the orthopedic problems in children, the main ones can be distinguished:

hip dysplasia

This common disease is diagnosed in the first months of a baby's life. Its clear signs are:

limited hip abduction
audible clicks on hip abduction
uneven skin folds
shortening of one of the legs, noticeable to the naked eye.

Learn more about the symptoms of dysplasia in children.

To understand the mechanism of this deviation, you need to remember the structure of the hip joint.

The acetabulum rests on the femur, and the head of the femur rotates within it. The head fits snugly into the cavity, and is covered with a vault from above.

With hip dysplasia, the head is not in place and requires fixation. For this, orthopedic devices are used that help to set it and fix it (cushion tires, Gniewkovsky's abduction apparatus, orthopedic struts,). In each case, the orthopedist determines the angle at which the legs are bred to “reset” the head. In mild forms of dysplasia, treatment may be limited to wide swaddling and massage, and in some more complex cases, the child's legs are plastered.

Dysplasia not detected in time threatens in the future not only with a wobbling gait, but also with more serious problems with the spine. In the treatment of this deviation with orthopedic devices, everything passes without a trace in a few months.

Clubfoot

Improper development of the bones of the foot or the muscles of the lower leg can lead to clubfoot. More often this phenomenon occurs in boys, then they stomp "like bears." This defect can be noticed with the first steps of the child. If you look closely, it seems as if it is braided in the legs. If parents do not take action, gradually develop disorders of the skeletal skeleton of the foot, and this may threaten subluxation. The muscles of the lower leg, which should work, remain unused and atrophy.

Orthopedists recommend not to go to extremes, but to apply massage and special exercises. As soon as the muscles return strength and the joints of the foot become mobile, splints or plaster bandages are applied for a while to fix the position.

walking on toes

Some babies around the age of 2 have a habit of walking on their toes. Such a nuance can be corrected by a neurologist, as this is usually associated with a disorder of motor activity. The treatment is a course of massage. Ignoring this habit can lead to a violation of the development of the bones of the foot.

flat feet

At the appointment with the orthopedist, an examination of the footprint is performed. Sometimes the joint can fall inward - this is the most important sign of developing flat feet.

Such a diagnosis at the age of 6-7 years is not a cause for great concern. In children of this age, the arch of the foot is not yet fully formed, therefore, preventive measures can eliminate the emerging flat feet. Such children are shown therapeutic exercises and wearing orthopedic shoes (orthopedic insoles).

/ Pediatric orthopedics: foot problems

Flat feet, clubfoot, curvature of the fingers, valgus feet - these and other orthopedic troubles can affect absolutely any child. Such diseases are congenital and acquired, but in both cases they do not pass without a trace. There is a deviation from the norm in the development of the baby. The task of parents is to take action as early as possible.

From the article you will learn about common orthopedic abnormalities in children.

Problems and causes

Let's start with flat feet - the most common disease in children. It is possible to understand exactly “it” or not only in children of 5-6 years old - with the normal development of the musculoskeletal system, the arch of the foot acquires the necessary shape for proper functioning.

It is very simple to determine the disease: it is enough to stand on a dry floor with wet feet - the imprint will be in full contact with the floor surface.

Factors affecting the development of flat feet:

heredity;
wrong shoes;
strong load on the legs;
excessive flexibility of the joints;
rickets (calcium deficiency in the joints), muscle paralysis.

Very often, parents do not attach much importance to this disease, because from the outside it is not very noticeable and, at first glance, does not have a negative impact. But this is far from true. Flat feet violates the spring functions of the foot (the ability to absorb 80% of the impact energy that occurs at the moment the foot touches the support while walking), depreciation almost disappears, as a result of which all the “unrest” during movement goes to the lower leg and hip joint - this can lead to arthrosis. Often, flat feet provoke the appearance of scoliosis, so prevention and treatment are mandatory conditions for children with such an ailment.

Large selection of orthopedic shoes for children and adults.

The girls found on one of the forums a girl's post about choosing children's shoes. But it's not the post itself that's interesting, but the comment prosthetist-orthopedist to him. I know that many of us are worried about the legs of our children. I highly recommend reading.

A comment prosthetist-orthopedist at the end !!!

Orthopedic surgeons and pediatricians recommend that parents of toddlers who start walking buy orthopedic shoes for their “first steps”. Orthopedic children's shoes contribute to the correct formation of the child's foot, the correct gait and posture.
Experts explain that Properly selected children's shoes greatly contribute to the prevention of flat feet and prevent other foot diseases.

flat feet- shape change feet, characterized by the omission of its longitudinal or transverse arches (these are two forms of flat feet, they can be combined). In all babies up to 2-3 years old, the longitudinal arch of the foot is flat and this is absolutely normal, because the baby's foot is just beginning to form and acquires "normal" outlines and contours by about 3 years. In an adult, the arches (arches) of the feet are normally concave and elastic, in a small child, in place of the arch, there is a fatty pad, giving the outline of a flat foot.

The foot is formed and acquires a classic appearance by 5-6-7-8 years, sometimes later. Until the age of 5-7, while the bones of the foot are formed in the child, the diagnosis of "flat feet" is not made.
The baby can be diagnosed with flat-valgus foot placement (one of the most common diagnoses in children under 5 years old) and varus foot placement. We can say that these diagnoses indicate a predisposition to flat feet.
Plano-valgus (x-shaped) installation of feet- the heel is deflected outward, the foot is tilted inward. The inner edge of the shoe with such a deformation is erased. Varus installation of feet (o-shaped), when the foot, on the contrary, is littered outward (similar to clubfoot). The outer edge of the shoe with such a deformation is erased. Such diseases are more common in physically weakened, often ill children, therefore, first of all, parents should do general health promotion and hardening.
If the child is physically active, does not complain about pain in the legs, the baby’s shoes do not wear off much on the inside or outside, then you should not worry too much and in advance about flat feet. In many other countries, such diagnoses are not considered serious at all.

In addition to special orthopedic (preventive and therapeutic) shoes and insoles, excellent prevention of flat feet are:
- walking barefoot on a carpet with a hard pile, in the summer on sand, small pebbles, grass and other uneven and uneven surfaces;
- massage paths (mats);
- cycling (if possible barefoot or in socks);
- climbing the Swedish ladder;
- massage and special exercises.

It doesn't matter what kind of shoes you choose for your child, orthopedic or anatomical, for the correct development of the child's foot, it is IMPORTANT that the shoes are light enough, comfortable and fix the foot well.

For the health of children's feet, the main thing is to choose the right shoes.
1. New shoes must be 0.5-1 cm longer than the foot(winter with a warm sock).
2. Shoes should fit the foot well, taking into account the anatomical features, this can be achieved Velcro and laces. Yes, and kids quickly learn to unfasten on their own, and later fasten such fasteners. Velcro is much more convenient than classic buckles and zippers for a child.
3. The presence of a molded hard back, it should be a single piece without seams and folds. For the little ones, the back should be high enough- it provides good fixation of the foot.
In the presence of such a heel and fasteners, the toe (toe) on children's sandals can be open. But it is advisable to purchase shoes “for the first steps” with a closed nose (round shape!), Because. babies often cling, stumble, knock on objects with their legs.
4. Shoes should fit the foot, but not be too narrow, this can lead to foot deformity, the toes should move freely.
5.The sole should be non-slip, with a slight heel lift(for babies, the heel height is recommended 5-7 mm, for children over two years old 1-1.5 cm), the rise should take at least 1/3 along the length of the sole. In such shoes, the baby will not shuffle, fall over, such a heel lift contributes to an even distribution of weight throughout the foot.
6. The material of the sole should be sufficiently dense, but flexible in those places where the foot bends. That is, the sole should be stiff in the back and supple in the toe, BUT do not bend in half! There should be no deep reliefs (drawings) on the sole of children's shoes.
7. Genuine leather is an ideal material for children's shoes. Alternatively, shoes with a textile upper and leather inside. Leatherette, rubber - very poorly breathable.
8. Curious observation - shoes made of red leather and suede, even from well-known manufacturers, often get dirty when wet. Therefore, for kids who can “miss” bright red shoes in their pants, I do not recommend it. The dye can stain socks, tights and clothes if the baby squats.
If you still opted for red boots and shoes, rub your skin thoroughly with a damp cloth (handkerchief), if a trace remains on it, then the shoes will get dirty.

Most parents (and I once was one of them) believe that the main thing in orthopedic children's shoes is supinator(sometimes incorrectly called a stupinator). First, this the mound on the sole (insole) is correctly called a slipper. Secondly, a real solid drawer is only in corrective orthopedic shoes (selected according to the prescription of an orthopedic doctor). By the way, if the shoes have a solid drawer and it is not in place (for example, the shoes are large) - this is very bad and can seriously affect the formation of the foot. Thirdly, the podvodnik (arch support pad) in conditionally orthopedic shoes is easily pressed by pressing and in most cases is not at all large, therefore it has a slight preventive effect.
In addition, there is an opinion that a large arch support (high and hard dowel) can interfere with the normal formation of the foot. In babies, instead of an arch support, the function of a shock absorber is performed by a fat pad located at the site of the arch (arch) of the foot. The bower should be soft and flexible to compress and straighten under the pressure of the foot. The foot must work on its own and it must have a stimulus for proper formation.

If you do not take into account the slipper, most orthopedic shoes can actually be called anatomical. Therefore, when choosing shoes for a child, it is necessary to look at the above points together: the correct bend of the sole, a molded hard back, good fixation. The insole can be removable, have a multilayer breathable structure, but in any case it (the inner surface of the shoe) should be practically flat, not counting the insole, sometimes there is a rise along the outer edging of the insole. The insole may have curves, but should not be strongly curved.

Seleverstova Elena Aleksandrovna, member of the All-Russian Guild of Orthopedic Prosthetists (13.12.2010)
Dear Anna! As a prosthetist-orthopedist, I want to consistently comment on your materials on the correct selection of children's shoes by parents.
1. Surgeons and orthopedists should recommend orthopedic shoes to children only in case of identified orthopedic problems. In other cases, children need ordinary shoes, but with structural elements that protect children's feet from the development of pathologies.
2. Regarding your description of shoes for healthy feet, I basically have no questions. I will touch on 2 points: a) backs are hard parts inserted between the top and the lining in the back (heel) part of the shoe. In ordinary children's shoes, berets can be of any height, but the backs should not exceed the height of the heels, even in children's shoes for the smallest children. The heels should wrap well around the heels, but should not be too high, so as not to force the Achilles tendon to work with excess tension when the foot is flexed at the ankle joint. High hard backs are needed exclusively in children's orthopedic shoes, if the child has an extremely sluggish or increased tone of muscles and ligaments in the ankle joints; if the child walks not from heel to toe, but on toes or from toe to heel, as in cerebral palsy, i.e., if it is necessary to normalize the stereotype of gait. But on the inner side surface of the shoe, the backs in ordinary shoes for babies should be elongated to the beginning of the 1st toe. In combination with the correct fasteners, shoes with hard elongated heels will protect the feet of children from the development of flat feet.
3. The following remark is perhaps the most significant. It refers to arch supports in children's shoes, so loved by parents and some orthopedists. By the way, in formal terminology there is no concept of "conditionally orthopedic" shoes. Shoes can be either orthopedic or regular, i.e. not orthopedic. Ordinary shoes in their design may be more correct (choose options according to your taste: rational, preventive, anatomical) or less correct, which depends on the level of professionalism and the level of conscientiousness of the shoe manufacturer. Orthopedic shoes are divided into simple and complex shoes. Before the development of capitalism in Russia, any orthopedic shoes were made according to the orders of patients. And it was right. Regardless of the severity of orthopedic problems, the features of the manifestation of these problems are diverse and differ in each patient. Just as it is impossible to treat all diseases with one castor oil, so it is impossible to recommend the same orthopedic shoes to all children. You correctly noted that a healthy child, in principle, does not need instep supports of the internal longitudinal arch in shoes. And if they are, then they should be quite low and resiliently soft. From such arch supports there will be no harm, but also special benefit. But then you are talking about high and hard insoles, which are available in most models of mass-produced low-complexity orthopedic shoes. You are concerned that these arch supports are not always located in the correct place. I want to ask you: “What do you think it is like a “submersible in the right place?”. I offer you and your parents the answer to this question. You are right, Anna, you said that the most common orthopedic problem in children is flat-valgus feet. You observe in a child the deviation of the heels outward and the obstruction of the feet inward. I’ll tell you a secret: in the state of support (when standing and walking), the feet fall inward at the articulation of the calcaneus, talus and scaphoid bones, i.e. anatomically - in the back!!! thirds of the feet. This means that a successful correction of the problem and the effect of rehabilitation can only be achieved if the foot is lifted and supported in its posterior third - with the hind arch support!!! foot section. And under the internal longitudinal arch, especially closer to the fingers, there should not be a high and rigid support. The human foot naturally got the opportunity to cope with shock support loads due to the presence of a spring function. This spring function should be provided by a system of bones, muscles, ligaments and tendons, from which a longitudinal-transverse arch is formed, elastically working under the weight of the body. Roughly propping up the internal longitudinal arch, preventing its work, one can successfully achieve the opposite effect - the development of flat feet. By the way, for children, as a rule, especially for babies, doctors do not initially diagnose “flat feet”. The mobile apparatus of the child's foot rarely shows signs of typical flat feet, when the foot falls under the weight of the body from top to bottom. In the absolute majority of cases, children have more dynamic manifestations of pathological conditions of the feet when walking. There are: blockages of the feet inward or outward, abduction and adduction of the anterior sections relative to the posterior ones, raising the edges of the feet, etc. All these signs are observed in children in different variants and quantities. The behavior and positions of the right foot may also differ from the behavior and positions of the left foot. If you have any doubts about the orthopedic well-being of your child, be sure to contact an orthopedist, find a competent specialist. In my experience, the greatest effect can be achieved by using individual orthopedic insoles, made taking into account the specific problems of patients, in any correct shoe (regular or low-complexity orthopedic).
Anna, the brands of shoes you mentioned do not cause any complaints, although I repeat: "You should choose not a brand, but a specific model of shoes." By the way, in your photo the child's legs are in not quite the right sandals. It is known that small children walk with a lot of emphasis on the first toe (see where the insoles in children's shoes are most worn and dirty). The structures of the anterior sections in babies are imperfect and work in excessively active movement. It would be much more correct to put on sandals for the baby, in which, in addition to the clasp through the ankle joint, there would be a clasp with one, and preferably two, straps along the back of the foot. By fixing the forefoot, you can significantly help the child in mastering the process of walking and contribute to the proper development of the child.
Anna! This concludes the review of your article. I hope you and your parents find it useful. Ready to answer other questions on the topic.

The formation of the musculoskeletal system continues from the moment of birth until the age of 15, which is why it is so important for parents to pay attention to the slightest deviations in the development of the child and contact an orthopedist in a timely manner.

The main orthopedic problems in babies are:

torticollis;
hip dysplasia;
flat feet;
clubfoot;
rachiocampsis.

Torticollis

If torticollis in an infant is caused by disorders in fetal development, it can be detected as early as the 1st month of life. The acquired (bone) form of the disease develops already at school age.

Congenital torticollis (muscular) is usually diagnosed in the hospital. If this does not happen, then pathology is detected at 2-3 months in boys and at 4-6 months in girls (the development of the musculoskeletal system in girls is slower).

Muscular torticollis is associated with a developmental disorder or pathological muscle spasm on one side. It manifests itself clinically already at the age of one month by constantly turning the baby's head in one direction. At 2-3 months. the head is turned and thrown back a little; at the same time, the scapula are deployed to the sides.

By 5-6 months, there is already asymmetry of the neck, face and shoulder girdle, curvature of the spine in the cervicothoracic region, a pronounced turn of the head. Later develops. It is difficult not to notice these manifestations.

From the first weeks or months of life, installation (or habitual) torticollis may also develop, associated with the constant position of the child in the crib. Sometimes the baby is carried on the same side in the arms. Such torticollis can be eliminated in a few weeks by placing the child alternately in different directions of the crib.

The earlier the pathology is detected, the more effective the treatment will be. Massage, therapeutic exercises, physiotherapy (electrophoresis with lidase, paraffin applications) are prescribed.

In the absence of the effect of conservative therapy (more often this happens when diagnosing torticollis by 6 months), a rather complicated surgical treatment is performed (after 1.5-2 years). If treatment is not carried out at this age, then after 6 years, even surgery is not always effective.

Watch the video about this disease:

hip dysplasia

It may not have clear manifestations in the first months of life and may not be diagnosed even by experienced orthopedists at the first examination.

Due to the weakness of the ligamentous apparatus, the head of the femur moves out of its normal position in the joint.

This may result in:

predislocation: the head of the femur moves freely inside the joint;
subluxation: the head of the femur can dislocate from the acetabulum at the joint and return to it;
true dislocation: the femoral head is outside the joint.

The incidence of pathology: preluxation and subluxation occurs in 1 out of 100 newborns, and true dislocation - in 1 out of 800-1000 infants. Moreover, 60% of children with dysplasia are first-born, and 30-50% had a breech presentation (the highest risk of true dislocation). Maternal hormones before childbirth also contribute to joint instability.

Before the age of 4 months, dysplasia is diagnosed using ultrasound, since the cartilage tissue of the femoral head is not visible on the radiograph until this age.

From the age of six months, you can notice the asymmetry of the skin folds and the different lengths of the baby's legs.

The unequal length of the limbs subsequently leads to a "duck" gait (waddle), lameness, walking on fingers, curvature of the spine.

Treatment should be prescribed by an orthopedist. Wide swaddling of the baby, with the help of which parents try to cope with the problem themselves, is not only ineffective, but can even lead to excessive stretching of the articular bag, i.e. to abnormal joint development.

Optimal is the use within 1-2 months. Pavlik's stirrups or Freik's tires. They help to ensure the correct position of the femoral head in the acetabulum, the normal development of the femoral head and ligamentous apparatus.

Stirrup efficiency reaches 95%. The timing of treatment is monitored by ultrasound.

If parents miss the treatment time before 6 months of age, then a closed hip reduction is performed under anesthesia. Until the age of 1.5 years, closed reduction is the main method of treatment.

At an older age, surgical treatment is performed.

flat feet

All children are noted at birth. Being engaged with the child in massage and gymnastics, parents strengthen the muscular-ligamentous apparatus of his feet. By the year when the child begins to walk, you need to choose the right shoes for the formation of a normal arch of the foot, formed by interosseous ligaments.

Shoes should have a small heel that lifts the heel and helps strengthen and develop the ligaments. A good fit is also important. Shoes with an open heel ("flip flops", sandals) up to 3 years are not recommended.

Foot deformity in the form of flat feet is the most common pathology of the musculoskeletal system. It is the arch of the foot that provides cushioning of the body during movement. There are 2 longitudinal and 1 transverse arch. The deformation of these arches leads to transverse or longitudinal flat feet.

There is also a congenital form (rare) of longitudinal flat feet, as a malformation of intrauterine development. It is diagnosed in the maternity hospital: the forefoot is "turned" outward, the sole has a noticeable bulge. One foot is most commonly affected. Treatment consists in the gradual correction of the defect with the help of plaster casts. If there is no effect, surgical treatment is carried out.

Children under 2 years of age have a flat longitudinal arch. The role of the shock absorber is performed by the fatty "cushion" on the sole. The process of foot formation continues up to 5-6 years. At this age, the presence or absence of acquired flat feet is determined.

Types of acquired flat feet:

paralytic (a consequence of damage to the nervous system, for example, with);
rickets (excessive elasticity of the ligaments with weakness of the muscles of the foot with or exhaustion of the child);
static (most common, develops due to overload with excess weight);
traumatic (after a fracture of the foot bones with damage to the ligaments and prolonged use of a plaster cast).

At 3 years old, the doctor can conduct a preliminary assessment of the foot and identify a tendency to develop flat feet or its initial manifestations.

Early signs of developing flat feet can be noticed by parents in a baby from 2-3 years old:

fatigue with a short walk (the child asks for a stroller or in his arms);
new shoes after 1-2 months of wear are trampled on the inner edge of the heel or sole, the top is deformed inward).

The earlier flatfoot is detected, the more favorable its correction is. Of the conservative methods, therapeutic massage and special exercises (skating with the feet of a special roller, etc.), physiotherapy, baths with sea salt are prescribed. Choosing the right footwear is also important.

Clubfoot

It is called a congenital deformity of the baby's foot. In this case, the foot has plantar flexion, is given and turned inward. In the process of child development, the deformation increases, the load on the outer edge of the foot increases, where calluses form.

Clubfoot ranks first among congenital pathologies of the musculoskeletal system and occurs in 1-4 newborns out of 1000, in 10% of cases it is combined with other malformations. More often there is a 2-sided anomaly, in girls in 2-3 p. less frequently than boys. In severe cases, deformity of the bones of the lower leg, ankle, knee and hip joints, muscle atrophy subsequently develops.

Possible causes of congenital clubfoot:

malposition;
oligohydramnios;
the impact of chemical hazards on the mother's body;

Congenital clubfoot is determined immediately after birth, the diagnosis is confirmed by ultrasound (examine the cartilaginous tissue of the foot).

The earlier the treatment is carried out, the more successful it is.

The main methods of treating clubfoot:

plaster fixation of the foot is applied from 5-7 days of life, the bandage is changed every 2 weeks; its efficiency is 58%;
plastering from 2 weeks of life using the Ponseti method: a special plastering technique with changing bandages every 5-7 days contributes to sprain; treatment lasts up to 2 months, after which the child is assigned to wear special fixing shoes; the efficiency of the method is about 90%;
super elastic constructions; splints are made from a special material with shape memory, allowing for permanent correction;
bandaging in combination with special gymnastics is used for mild defects;
surgical treatment according to various methods (with the ineffectiveness of conservative treatment, with late diagnosis);
shin and foot massage (toning and relaxing), as a component of complex treatment;
kinesitherapy (active therapeutic exercises) or manual therapy aimed at increasing muscle activity, stretching tissues;
physiotherapy to increase muscle extensibility and contractility, improve blood circulation; applied after 2 years;
drug therapy: the appointment of drugs that improve the patency of nerve impulses (vitamins of group B, prozerin).

Curvature of the spine

There are quite a few reasons for the occurrence: hereditary predisposition, birth trauma, different leg lengths, etc.

With different leg lengths (common pathology), at an early stage it is necessary to use orthopedic insoles, selected by a doctor, to align the pelvis, prevent the development of scoliosis and form the correct curves of the spine.

Already at the age of 2-3 years, the orthopedist assesses the correct posture, the condition of the feet during examination. Longitudinal flat feet will lead to the occurrence of static scoliosis in the future (curvature of the spine to the side), and transverse flat feet to static scoliosis (curvature of the spine in the anterior-posterior direction). The combination of both types of flat feet will cause kyphoscoliosis.

In addition, infantile (idiopathic) scoliosis can be detected in infants. It is less common than in older children. It is detected by pediatricians when examining a baby in the prone position: the spine has an arc, and the fossa on the back of the head is not in line with the intergluteal gap.

But more often this pathology is detected at 5-6 months, when children sit confidently. It becomes noticeable that in the sitting position the baby does not have a straight back, but the head is somewhat tilted to the side. In these cases, the orthopedist prescribes an x-ray of the spine to rule out other causes of scoliosis.

Infant scoliosis can be corrected within 2-3 months with the help of therapeutic exercises selected by the doctor. It can be carried out daily by an exercise therapy methodologist or a mother trained by him. In severe cases, exercise therapy supplements the use of a plaster "crib", in which the child is placed at night and for several hours during the day.

The outcome of untreated idiopathic scoliosis varies: in some cases it resolves spontaneously, in others the prognosis is very poor. The earlier infantile scoliosis is detected and treated, the better the prognosis. Up to 2 years, the deformity may reverse, but self-healing is rare. With the initial development of idiopathic scoliosis in children after 2 years, the prognosis is unfavorable.