Buckle foot in children

synonym

Pes valgus, buckled foot, childlike buckled foot

English: talipes valgus

definition

Under the term Buckle foot one understands in medicine a pathological one Misalignment of the foot. The classic articulated foot has a lowering of the inner (medial) Edge of the foot with a simultaneous elevation of the outer (lateral) Edge of the foot.
In addition, when looking at the heel, a so-called X position observe. That means the heel in relation to the leg at the level of Ankle appears bent outwards.

introduction

While the buckle foot in adults is always called morbid (pathological), it is physiological in children and does not need to be treated. In many cases, children who suffer from bent feet also show Misalignments in the form of a countersink or Flatfoot on.

As a rule, the position of the feet changes up to the age of 9. However, the buckle foot should be up to the age of approximately 8 to 10 years do not disappear or slide further inwards, a doctor should be consulted. Following an extensive diagnosis, the doctor can determine the most suitable treatment method.

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Further information about myself can be found at Dr. Nicolas Gumpert

causes

A distinction is made between congenital and acquired causes for the causes of buckled foot. In children, the presence of the buckle foot is in the majority of cases due to genetic malformations.
However, the knee joint in children is mostly completely harmless and only arises while learning to walk. Due to the not yet fully developed holding apparatus in the area of ​​the legs and feet, children are forced to turn their feet inward while running. From this basic position, children tilt the heel to compensate. The result is the development of a buckle foot.
This phenomenon is perfectly normal and usually resolves completely as you grow up. When a broken foot develops in older children or adults, both the causes and the consequences are more serious. Possible reasons for the development of a buckled foot in older children can be accidents, paralysis, infections or incorrect loading of the foot. In rare cases, a rheumatic disease can also be responsible for the development of the knee joint in children. Especially those children who suffer from massive overweight (obesity) develop a buckled foot as they grow up.
One of the most common causes of a buckled foot in children is ligament instability in the area of ​​the foot. Due to a lack of stabilization, the children are unable to keep their heels upright. In this way, the longitudinal vault is lowered in the long term. Since strong muscular forces act on the foot even with weak ligament structures, the ankle bone moves inward over time (medial). The calcaneus, on the other hand, is increasingly shifted outwards. As a result, there is a prominent protrusion of the inner ankle.

You can find more information on our website: When should I start putting shoes on my child?

Symptoms

The presence of the knee joint usually causes it in the affected children no symptoms. If there are no other misalignments, the children usually feel no pain.
In a few cases it can lead to a pronounced buckling foot Pinching the calcaneus (Calcaneus bone) come. This causes severe pain in the outer ankle area (Lateral malleolus). In children, the buckle foot only rarely leads to the development of a arthrosis. If this is the case, severe movement disorders will develop over time.

Risks and Consequences

If the deformity does not regress within the first decade of life in children with bent feet, treatment should be initiated as soon as possible. The longer the feet are put under the wrong load, the more the adjacent joints are affected. Especially in the field of Ankle and knee joints strong in the long run Signs of wear and tear.
In many cases, the affected children quickly develop one arthrosis. In children with undiagnosed (and therefore untreated) buckle feet, regular exercise can be increased early on Knee problems to lead.
The effects of the misalignment are usually not limited to the affected foot. Most often, the articulated foot in children affects the entire statistics of the body. Affected children develop over time X or O B settings. In addition, the wrong weight distribution can also affect the whole Spine impact. As a result, it can become a complete deformation of the Lumbar spine come. Affected children then develop strong ones Back pain which can radiate into the buttocks.

diagnosis

Most children can already be diagnosed with "buckled foot" pure consideration of the foot and the leg axis be asked. On closer inspection, a buckled foot in children can already be recognized on the shoe. Parents should contact their child if they suspect buckle feet Signs of wear and tear pay attention to shoes. Classically, the shoes wear out very heavily on the edge areas after just a few days. The specialist will first perform a simple clinical examination in the course of the buckle foot diagnosis.
Viewing the barefoot child from behind enables an assessment of the foot axis. In healthy children, the angle between the lower leg axis and the heel is approximately five degrees. If there is a buckle foot, this angle is greatly increased. In addition, the knee foot in children falls due to a decreased Varus position (The joint axis is bent outwards) the heel when standing on the toes. This phenomenon is due to an insufficiency of the lower leg muscle (Tibialis posterior muscle). In addition, show strongly pronounced Calluses on the outer edge of the sole of the foot for the presence of a buckled foot.
Imaging procedures such as X-rays are usually used in the diagnosis of buckle foot in children not helpful, since malpositions cannot usually be represented in this way.
By making a so-called Podograms (Footprint) the attending physician can depict the child's foot silhouette. In this way, the inner arch of the foot can be displayed and assessed. If there is a buckled foot in children, the podogram shows a clear one Flattening of the inner arch of the foot.

therapy

The treatment of buckle foot in children depends on the extent of the deformity.
As a rule, therapy does not begin until the age of eight to ten years, since buckled feet often develop up to this point spontaneously regresses.
In general, if a buckle foot is present, all possible non-surgical measures should be exhausted before surgical correction is considered. In the case of a slightly developed articulated foot, simple ones usually help Gymnastic exercises correcting the axis of the foot. This is recommended especially for children (but also for adults with buckled feet) To run barefoot on natural soils. In addition, choosing a shoe with a firmer sole can have a positive effect on the stability of the affected foot.

If no additional malalignment in the form of a flat foot is diagnosed in children with arched feet, special ones help Heel lengths correcting the buckle foot. However, since the majority of children with buckled feet are also trained as a Arch arches can often be observed Custom insoles be prescribed. After evaluating the exact incorrect load pattern, these insoles are made in such a way that the affected foot is supported primarily on the inside. In this way, the distribution of body weight can be balanced and possible long-term consequences can be prevented.
For overweight (obese) children with buckled feet, in addition to the non-surgical treatment measures, the Weight reduction stand in the foreground.

Only if a buckle foot in children does not regress despite years of physiotherapy and / or symptoms (for example pain or problems walking) should one surgery should be considered. In everyday clinical practice, two procedures are used for the surgical correction of the buckle foot in children. Through the so-called "Soft tissue surgery“The aim is to improve the pull of the muscles and thereby lift the arch of the foot. The "Bony operation“Is mainly used in children with a pronounced buckle foot.

forecast

As a rule, the buckle foot shows one in children good healing process and therefore has a good prognosis. Even without surgical intervention, the deformity can be corrected quite quickly with conservative treatment measures.
With early diagnosis and rapid initiation of suitable therapy, the affected children hardly any late effects prove.
Years of wearing special insoles may only be necessary if the knee foot is very pronounced.