How to diagnose and intervene in children's foot eversion?
Foot eversion, also known as outward extension of the foot, refers to the outward deviation of the heel axis in children, which is one of the common deformities of the foot. Foot eversion is a deformity caused by abnormal development of the foot tendons, accompanied by flat feet and scaphoid collapse. The three-point line connecting the midpoint of the lower leg, the center of the Achilles tendon, and the center of the heel bone forms a shape. In addition, eversion of the foot can also cause ankle joint eversion deformation.
Let's learn about the specific situation together~
Manifestations of neonatal foot eversion
1. After birth, there may be unilateral or bilateral deformities of varying degrees in the feet, with ankle joint plantar flexion, inversion, and adduction deformities.
2. When the child is learning to walk, they use their forefoot or lateral edge of the foot to walk on the ground. As they age, the deformity gradually worsens, and in severe cases, they walk on the back of their foot, with sliding sacs and calluses appearing at the weight-bearing area.
3. X-ray imaging, lateral position of affected foot: After birth, the ossification centers of the talus, calcaneus, and sphenoid bones can be seen on the X-ray, and sometimes the third wedge bone can be seen. All metatarsal and phalangeal bones have appeared, while the ossification center of the tarsal navicular bone does not appear until the age of 3.
4. Estimate the deformity based on three lines: (1) Measure the heel angle on the radiograph. If it is less than 30 °, it indicates no inversion of the foot; (2) Measure the angle at which the longitudinal axis of the first metatarsal bone intersects with the longitudinal axis of the talus, which is normally between 0 ° and 20 °; (3) The angle formed by the longitudinal axis of the talus and the plantar surface of the calcaneus measured by X-ray lateral view is normal at 35 ° -55 °. If it is less than 30 °, it indicates foot prolapse. If the distance from the heel angle is less than 15 ° and the angle formed by the intersection of the first metatarsal bone and the longitudinal axis of the talus is greater than 15 °, it indicates subluxation of the tarsal joint (Simon's 15 ° law).
How to deal with neonatal foot eversion? Diagnostic basis for foot eversion
1. When the eversion of the newborn's foot is not severe, manual correction can be used to make the foot droop and inversion persist for a hundred times a day. With age, it can gradually recover to normal under correction. Alternatively, the method of wrapping cotton pads on the outer side of the ankle joint can also be used. Regardless of the method, this deformity can generally recover to normal shape within about 3 months without leaving any sequelae. Specific methods: Massage and massage the inner muscles of both lower limbs during the day, and adduct, invert, and internally rotate the foot; Twice a day, 30-40 times each time. Tie your lower limbs together or secure them with a small splint during nighttime sleep. In addition, babies should be given appropriate calcium and vitamin D supplements, and exposed to more sunlight.
2. The Pan Seti method is most effective for children who start treatment within 9 months (preferably shortly after birth). For children between 9 and 28 months old, this treatment method is still effective and can correct all or most of the deformities. 28 months later, the Pan Seti method
Still effective, but most children will require surgical treatment at the same time. Summary of treatment methods: ① Manual therapy - After several weeks of manual therapy, the various bones of the foot are reduced back to near normal
The deformity of the foot is gradually corrected in its normal position Gypsum casting - After each manual treatment, the feet and calves are cast and kept for 5-7 days
Heaven, to maintain the position of the feet Repeat steps 1 and 2 until the foot is corrected to the correct position In order to completely correct the foot, doctors usually cut the Achilles tendon. This minor surgery is in progress
Under partial anesthesia, it only takes 10 minutes Support - After the last plaster is removed, it will be immediately installed for your child
A wearable brace: a. Keep wearing it for 3 months, wearing it for 23 hours a day. b. Wear it every time you sleep for the next 2 to 4 years. Note that braces are a crucial part of treatment. Even if your child's feet look like
After returning to normal, but if they don't wear it every sleep time, their feet may still turn back, even after more than two and a half years of orthodontic treatment.
3. Rehabilitation therapy is suitable for older babies with eversion of the foot who have already undergone treatment. Its main function is to provide rehabilitation and help the baby recover to normal as soon as possible. Exercise therapy: ① Reduce the tension of the triceps and chordae muscles in the calf. ② Squat up training: When squatting, the knee joint should be flexed 9 degrees, and when standing, the knee joint should be at 140160 degrees to avoid overexertion Prone position calf flexion and extension training can improve the tension of the hamstring muscle and increase the stability of the knee joint. Single leg kneeling and standing position training is beneficial for improving knee joint control ability Crawling training and knee joint flexion position are beneficial for correcting knee inversion, while increasing knee joint control ability and coordinating their movement ability. Knee joint flexion and extension are training for back flexion, improving extensor muscle strength and coordinating antagonistic muscle ability Stretching and muscle strength training for the calf triceps involves placing the child's forefoot on a step and heel on the ground, training the child to lower and lift the forefoot, which is the most necessary strength training during the swing phase Bridge building training enhances extensor strength, promotes hip joint extension and flexion, and corrects trunk flexion Step up and step down training has a significant effect on correcting knee joint rebound and coordinating gait. Pay attention to maintaining slight flexion of the knee joint Weight therapy training is beneficial for improving knee joint stability and increasing proprioception twice a day. Tuina massage: It has the functions of unblocking tendons and collaterals, promoting blood circulation and removing blood stasis, promoting joint movement, and basic techniques such as joint range of motion massage and segmental massage to promote muscle strength. Acupuncture and moxibustion: tonify qi and blood, dredge meridians, stimulate acupoints, and improve the pathological state of internal collaterals of the body through acupuncture and moxibustion. The main points are Zusanli, Sanyinjiao, Yanglingquan, Chengshan, Naoqing, Heping, Xuehai, Liangqiu, Yinlingquan, etc.
The diagnosis of hallux valgus is based on the presence of one or both plantar flexion and inversion deformities in the baby's feet after birth. Anterior adduction and inversion of the foot, plantarflexion of the talus, inversion and plantarflexion of the calcaneus, contraction of the Achilles tendon and plantar fascia. Widening of forefoot and narrowing of heel
Small, high arch. The lateral malleolus protrudes forward, while the medial malleolus protrudes backward and is not obvious. When standing and walking, the outer edge of the plantar bears weight, and in severe cases, the outer edge of the dorsum of the foot bears weight, resulting in the formation of a sliding sac in the weight-bearing area
Inflammation and calluses. Unilateral deformity, walking limp, bilateral deformity, walking swaying. X-ray imaging: The angle between the longitudinal axis of the talus and the first metatarsal bone is greater than 15 °, and the metatarsal plane of the calcaneus is
The angle between the longitudinal axis of the talus is less than 30 °.
The daily diet of patients with eversion should include high calcium foods. To ensure the normal needs of bone metabolism. Eat more milk, eggs, soy products, vegetables, and fruits, and supplement calcium supplements if necessary. Eat more foods rich in vitamins. In daily diet, try to eat more vitamin rich foods such as vegetables and fruits, and avoid high-fat foods as much as possible. Eat more high protein foods. For patients with valgus foot, they need to be supplemented with rich nutrition, especially protein. They can usually eat milk, eggs, soybean milk and meat. Overweight individuals should control their diet, increase physical activity, and lose weight to help reduce joint burden.
Eat more carbohydrate rich foods. The staple food of patients with valgus foot is mainly rice, pasta, Congee and other carbohydrate rich foods, so as not to hinder nutrition absorption due to excessive food.
Suitable for eating seashells. High protein content, rich in calcium, can improve the immune function of the body. 200g steamed for consumption. Twice a week.
It is recommended to eat milk. High protein content can promote tissue protein synthesis and is suitable for consumption after surgery for this disease. Drink 250-500 milliliters directly.
Oysters are suitable for consumption. Rich in zinc element, it can improve the immune function of the body. Reduce the possibility of postoperative infection and inflammation in this disease. 5-8 per day. Steamed for consumption.
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