Heel varus deformity

General information

Heel varus deformity is a pathology in which the heel is set in the form of the letter “O.” As a result, the child rests on the outer lateral surface of the foot when walking, and the toes start to look inward. In the absence of correction, pathology leads to a violation of the formation of the skeleton, deformation of the shins, knees, and hips, and joint diseases. Experienced pediatric orthopedists diagnose and treat varus deformity of the feet in children and stabilize the position of the lower limbs, in general. 

The musculoskeletal system of a young child differs significantly from that of an adult. Bones, joints, and ligaments are not yet fully formed; tissues are characterized by increased elasticity and softness. As a result, excessive and improper loading, if repeated constantly, can cause deformities.

As a rule, parents discover varus deformity of the feet when the child starts walking, but they turn to an orthopedist much later. Meanwhile, the position of the feet becomes more and more rigid every year, and the uneven distribution of load on the legs leads to progressive posture disorders and deformities of the lower limbs.

Classification: types and degrees of a feet varus deformity

The cause of the development of orthopedic pathology allows us to distinguish several types of varus deformity of children’s feet:

• static: caused by poor posture;
• structural: associated with a developmental defect in the talus;
• rachitic: caused by vitamin D deficiency and rickets;
• paralytic: occurs as a complication of neurological diseases (encephalitis, poliomyelitis);
• spastic: formed by muscle spasms (e.g., against the background of cerebral palsy);
• compensatory: occurs against the background of congenital deformities of the ankle, Achilles tendon, shin bones;
• traumatic: develops with trauma to the foot, ankle joint, and tibia;
• hypercorrective: associated with improper orthopedic correction of other disorders.

Causes of varus foot deformity in children

The disease can be congenital or acquired. In the first case, the peculiarities of the foot position when walking are caused by a violation of intrauterine development. Risk factors, in this case, are multiple pregnancies, fetoplacental insufficiency, diseases of the endocrine system, and bad habits of the future mother. Hereditary predisposition also plays an important role.

Acquired deformity, as a rule, begins to form when the child takes its first steps. Often, parents themselves contribute to the development of pathology, forcibly putting the baby on his feet when he is not yet ready for it. The risk of developing the problem increases with calcium and vitamin D deficiency, improper footwear selection, injuries to the musculoskeletal system, chronic diseases, and frequent infections that weaken the body.

Symptoms of varus deformity of the lower limbs in children

Signs of varus deformity of the foot:

• Support on the outside of the foot when walking in combination with heel separation and toe separation;
• abrasion of the sole of the shoe on the outside of the shoe;
• insecure gait, frequent falls;
• reluctance of the child to walk and run for long periods, and at an older age, complaints of leg pain when walking for extended periods;
• leg curvature, difficulty straightening the knees.

The appearance of such problems requires mandatory examination by an orthopedist.

Diagnosis

Pathology diagnosis is carried out by a pediatric orthopedist based on a comprehensive examination. Initially, the doctor gets acquainted with the young patient and his parents, clarifies their complaints, and when specific symptoms appear. Attention is paid to the course of pregnancy and childbirth, diseases, and injuries. Then, the specialist proceeds to visually inspect the child, assessing posture and foot placement and identifying other characteristic signs. To confirm the diagnosisare used:

• Plantography: assessment of foot load distribution during standing;
• X-rays of the feet;
• CT or MRI of the feet and lower extremities.

If necessary, the list of examinations is expanded.

Treatment methods for varus deformity of the feet in children

The treatment choice depends on the child’s age and the degree of deformity. In the mild form of the disease, wearing orthopedic shoes, physical therapy, and massage are sufficient. A natural stimulation of the feet while walking barefoot on grass, sand, pebbles, etc. has a good effect. At home, it can be replaced by special mats.

In case of significant deformity, plaster casts are used to correct it. They fix the foot in the correct position, helping restore its normal anatomy. Between plastering sessions, massage courses, physiotherapeutic procedures, and therapeutic gymnastics are performed.

Extremely severe cases that cannot be treated conservatively require surgical correction. It is a long and complicated process requiring an Ilizarov apparatus or osteotomy of the shinbone and foot bones.

All these treatment options are available in more than 760 hospitals worldwide (https://doctor.global/results/diseases/heel-varus-deformity). For example, Ankle osteotomy can be performed in these countries at following approximate prices:

United States $4.0 K – 25.2 K in 23 clinics

Turkey $5.2 K in 29 clinics

China $15.9 K in 6 clinics

Israel $18.8 K in 16 clinics

Germany $23.6 K in 45 clinics.

Prevention

Often, parents of children think about what to do and how to be, but only when the varus deformity of the feet becomes clearly visible. Meanwhile, the earlier the problem is detected, the easier it is to cope with it, and compliance with preventive measures will help to avoid the development of pathology. Orthopedists recommend:

• Do not force the process of standing on legs if the baby does not try to do it himself;
• Choose good quality shoes that lock the feet well;
• Let your child run barefoot regularly, including on uneven surfaces and/or special mats;
• provide a nutritious diet with sufficient vitamins and micronutrients;
• Avoid overeating and obesity;
• Ensure adequate age-appropriate physical activity;
• See an orthopedist regularly and follow his or her recommendations.

Varus deformity of the feet is not only an aesthetic defect. Over time, the pathology only progresses and leads to many problems with the musculoskeletal system. Experienced orthopedists in the pediatric department will help to identify and correct the problem in time.