Causes of deformation of the knee joints

Types of patella deformities

Crooked legs at the knees are considered normal in children under two years of age, which is due to the characteristics of their physical development. But if a deviation from the norm, noticeable to the naked eye, persists at a later age, it is worth visiting specialized specialists. There are two types of pathology:

hallux valgus;
varus deformity.

In the first case, the kneecaps shift inward, this position is called an x-shaped deformity of the knee joint. In the second case, on the contrary, the knees seem to be turned outward; they often say about such children: their legs are like wheels. It is noteworthy that such deviations most often occur in young children and the elderly: this is a consequence of serious disorders of the musculoskeletal system.

Hallux Valgus deformity of the first toe

Please see the information on what to expect after surgery in a separate section of our website.

You must understand that the information presented below is a general view of the rehabilitation process, and each person will have their own rehabilitation period; for some it will last longer than stated here. The information presented will help you understand your own feelings and various treatment methods used during the rehabilitation of patients. The time frame we have outlined is a minimum program. When deciding to have surgery, you should understand that healing and rehabilitation may take longer.

Early postoperative period

Almost all patients after surgery for hallux valgus deformity of the 1st finger are discharged from the clinic on the day of surgery or the next day.

After surgery, your foot will have a bandage similar to the one shown in this photo.

Postoperative dressing

Please do not remove the bandage yourself. You will also be recommended a post-operative boot with a rigid sole and forefoot relief. Every time you go anywhere, please remember to wear it.

Post-operative boot with hard sole

For the first 48 hours after surgery, you are allowed to walk using two crutches. Crutches are necessary to maintain stability when walking in special shoes. After this period, you can load your foot as much as your own sensations allow, without forgetting to wear post-operative shoes. You will discuss the use of crutches and possible weight-bearing with your physiotherapist immediately after surgery and before leaving the hospital.

In the first 2 weeks after surgery, try to elevate your foot and keep it in that position 95% of the time. During this entire period you are advised to stay at home.

Elevated position of the foot and ankle joint

Most people certainly don't have a functional bed at home like the one in this photo. However, the same effect can be achieved on a regular bed or sofa by placing a pillow under your feet. You should not put your feet in an elevated position when you are sitting on a chair. And once again we advise you to stay at home for the first two weeks.

To minimize the risk of infection, keep your feet dry and cool. Avoid excess humidity and heat. When showering, wear a sealed bag over your foot.

In order to prevent venous thrombosis, regularly perform movements in the foot and ankle joint. Drink enough fluids. If you have risk factors for thrombosis, be sure to tell your doctor about this; if necessary, he can prescribe you anticoagulants.

Two weeks after surgery

You will be examined by your doctor and your dressing will be changed.

Normal appearance of the foot 2 weeks after surgery. This patient strictly followed all the recommendations and after two weeks her wound was completely healed, the swelling was minimal.

The wound should be dry; redness, if any, should be minimal; bleeding and slight to moderate swelling may be visible. If you do not elevate the foot, swelling will be more pronounced and healing will be slower.

At this stage, if the swelling has been sufficiently relieved, it is recommended to keep the foot in a horizontal position 75% of the time during the day. At night, it is recommended to place one pillow under your foot. It is also not recommended to stand or walk for more than 15 minutes at a time, otherwise the foot will become swollen and painful. You must wear post-operative shoes for another 3 weeks. You are allowed to go outside for a short time; the duration of walks is limited by pain and swelling of the foot.

Driving a car is only allowed if your left foot has been operated on and your car has an automatic transmission. If the right foot has been operated on, it is recommended to drive no earlier than 7-8 weeks after the operation. This is due to the fact that you must press the brake pedal with your right foot, and sometimes this must be done very quickly and strongly; with a sore foot, you simply cannot do this, which makes driving unsafe.

Measures aimed at reducing the sensitivity of the scar begin only after the wound has completely healed. For this purpose, you can use a special cream that should be rubbed into the scar area and around it.

Exercises aimed at restoring the movements of the small fingers begin 3 weeks after surgery and continue for 3 months. These movements include active with resistance and passive flexion and extension of the fingers. Classes should also include exercises aimed at strengthening your own foot muscles.

Six weeks after surgery

Before your visit to the doctor, you will have a control x-ray. Your doctor will examine you with these images and you will have the opportunity to compare the radiographs before and after surgery. Signs of fusion usually become visible no earlier than 6 weeks after surgery, sometimes later; in smokers they may appear only 3 months after surgery.

At this stage, if the healing process is proceeding favorably, the swelling and hemorrhage should have almost completely disappeared, although some swelling may persist for up to 3-4 months.

You will be able to wear regular shoes approximately 8 weeks after surgery (subject to any residual swelling), although we still recommend wearing hard-soled shoes.

Three months after surgery

Photos of the foot before and after surgery

If you are satisfied with the result, then this is your last visit to the doctor.

Why do knees become deformed?

There are quite a few reasons why pathology develops. Among them are uneven muscle development, which leads to displacement and inversion of the knees, injuries, age-related changes in bone tissue, and the presence of various diseases. For example, valgus deformity of the knee joints most often develops due to an increase in the expansion of the joint space due to the intensive development of the condylar articular bones, which is usually observed in children. An older person may experience curvature of the knee joint due to sprained ligaments, as well as against the background of the development of other diseases - arthrosis, obesity, dysfunction of the nervous system, brain damage (stroke).

Congenital curvature of the knee can be caused by:

Lack of calcium and vitamins in a woman’s body during pregnancy.
Ingestion of toxins into the body of the expectant mother, as well as the use of certain types of antibiotics.
Problems with the endocrine system in a woman in labor.
Unfavorable heredity (parents, grandparents had similar diseases).
Birth injuries.

A child may have problems with knee joints due to excess weight or lack of vitamin D, which leads to the development of rickets. Often it is vitamin deficiency that causes hypermobility of the joints and leads to the baby’s knees bending backwards. Another source of trouble is improperly selected shoes with soft soles and without backs, which can cause problems with the joints.

In older people, diseases of the musculoskeletal system are quite common. The main reason is weakening of muscles and ligaments, problems with bones. Gout, arthritis, gonarthrosis, and excess weight are additional risk factors that can lead to scoliosis of the knee joint. In women, high heels can provoke pathology of the knee joint. And, of course, you shouldn’t discount injuries, even the most minor ones. Sometimes a slight blow to the kneecap area is enough to cause it to become deformed over time.

How to correct X-shaped leg deformity in a child

Most often, hallux valgus deformity of the lower extremities develops due to excessive load on the baby’s legs during verticalization. The reason may be starting to walk too early - in such cases, the muscles and ligaments are not yet formed enough to hold the child’s legs in the correct position, and poor coordination aggravates this problem, since when walking the baby spreads his legs too wide for stability.

The formation of X-shaped legs can also be caused by the child being overweight. However, if there is no excess weight, pathology more often develops in asthenics rather than in hypersthenics, which may be due to congenital weakness of the musculo-ligamentous apparatus, which is more typical for people with an asthenic body type. Girls suffer from hallux valgus more often than boys due to the structural features of the pelvis associated with the sex of the child, while the wider the pelvis and the shorter the femurs, the more pronounced the X-shaped curvature of the legs can be.

Children get tired quickly and often complain of pain in the lower extremities. Their gait becomes awkward and uncertain. An orthopedic doctor will determine an accurate assessment of the severity of pathology in a child. If in a child under 4 years of age this distance exceeds 4-5 cm, further examination, conservative treatment, possibly orthotics and dynamic observation 3-4 times a year are necessary.

Long-term absence of correction of hallux valgus deformity entails anatomical changes in the knee joints, feet, and in some cases, the spine. The lack of positive dynamics after a course of physical therapy and massage suggests the inclusion of physiotherapeutic procedures in the treatment, in advanced cases of orthosis with splints on the lower extremities.

Long-term absence of correction of valgus deformity of the legs leads to the fact that the internal collateral ligaments of the knee joints are overstretched, the joint becomes unstable, and its lateral hyperextension occurs. The feet of patients with X-shaped legs acquire a flat-valgus position, flat feet are formed, which makes walking even more difficult, causes pain and increased fatigue after exercise.

If you take care of prevention in time, you will not have to resort to extreme measures.

A set of exercises for X-shaped leg deformities.

Therapeutic gymnastics plays a special role in X-shaped leg deformities:

It is useful to teach a child to walk like a “bear” on the outside of his legs;
teach your child to squat with a ball or soft toy clutched in his knees, perform 2-3 sets of 15 squats;
let the child sit on the floor on his knees, spread them as wide as possible and lean forward, stretching his arms as far as possible (you can offer to reach for a toy), perform 2-3 approaches 10 times;
Exercises with raising a straight leg as high as possible from a position lying on your side are useful; perform 2-3 sets of 10 lifts with each leg;
Let the child stand with his legs crossed at the ankles and slowly sit down on the floor in a Turkish style; if that doesn’t work, you can hold him by the hands and repeat the exercise 10 times.

Wall bars, cycling, and swimming in the pool are also effective. Walking on your toes and heels along a narrow path or board, on the outside of your feet, adopting a cross-legged sitting position, and squats with a ball sandwiched between your knees are very useful.

If the child is too young to perform these exercises, try to turn them into a game, do them yourself and let the child repeat after you.

To monitor the dynamics of the disease, you should visit an orthopedist every three months.

When to contact specialists

Visual curvature of the legs is a good reason to make an appointment with an orthopedist. The exception is children under 2 years of age, in whom signs of deformation of the knee joints are a consequence of the natural growth of the body and disappear over time. The presence of pain in the knees with a visible change in their position is also grounds for contacting a specialized specialist.

The sooner a medical examination is performed, the higher the chances of getting rid of the pathology and at the same time maintaining health. After all, curvature of the legs can cause serious dysfunction of the spine and internal organs.

Diagnostics

If you have the slightest suspicion of the development of Hallux valgus in a child, you should consult an orthopedist. Initially, the doctor will conduct a survey and find out what worries the patient most. Then, both feet of the child must be examined. In this case, the orthopedist pays attention not only to the deformation of the thumb, but also to:

flattened forefoot;
the presence of redness and swelling in the projection area of the metatarsophalangeal joint;
condition of 2 and 3 fingers;
condition of the skin of the plantar part of the foot.

After the examination is completed and there are signs of hallux valgus, instrumental studies are performed:

radiography of the feet in 2 projections - the resulting images allow you to accurately determine the angle of deviation of the big toe and the size of the intermetatarsal angle;
computer plantography is a method that involves obtaining prints of the plantar parts of the foot while standing;
CT and MRI are auxiliary diagnostic methods prescribed when there is a suspicion of the development of complications and the need to detail the nature of changes in the condition of the bones of the foot and soft tissues.

Thus, examination and diagnosis of Hallux valgus does not cause any discomfort to the child and can, in most cases, be carried out within one day. Based on the results obtained, the orthopedist makes a diagnosis indicating the degree of deformation and prescribes treatment appropriate to the situation.

What can doctors offer?

Treatment of knee joint deformity is complex and is selected depending on the reasons that led to the development of the pathology. In most cases, children are prescribed vitamins and medications, as well as physical therapy. For adults, strengthening physical procedures and painkillers. Special orthopedic devices are usually used to straighten the legs; in some cases, surgical intervention is advisable.

In each specific case, treatment is prescribed after a thorough medical examination. Consultations with related specialists are often required: endocrinologist, neurologist, cardiologist.

Causes of dyspraxia

The causes of dyspraxia are not completely known, but recent neurophysiological research indicates that the disease may be caused by underdevelopment or immaturity of brain neurons, rather than by their damage. Hypoxic-ischemic brain damage in the perinatal period plays a special role in the development of this disease.

Violation of praxis (the ability to perform purposeful movements) can only be diagnosed after the seventh year of life, when it can be distinguished from coordination disorders and motor disorders.

The diagnosis of dyspraxia can only be made by a pediatrician or a pediatric neurologist or neuropsychiatrist.

Manifestations of the “awkward child” syndrome:

Delayed physical development.
The child slowly learns to dress and feed himself.
The child is sloppy when eating, does not use a knife or fork well
Difficulty performing any purposeful actions
The child cannot or does not jump well, does not ride a bicycle well, often falls out of the blue and stumbles when walking.
The child plays ball poorly.
There are difficulties in writing and drawing.
Various psycho-emotional and behavioral complexes.
Unstable and sluggish posture.

Children with this diagnosis experience certain difficulties in social relationships; peers often refuse to contact them. It is not easy for an “inept” child to match healthy children in everyday life. Such children are characterized by increased fatigue, because their energy expenditure on performing ordinary daily tasks is much higher than that of healthy peers.