What Is a Varus Deformity?

Foot varus deformity is a state of subluxation with the boat joint, which fixes the foot in an adducted and supinated position. Newborn babies have small heels on one or both sides, forefoot adduction, varus, increased skin texture on the inside of the foot, thinning of the lateral and dorsal side of the foot, and the heel cannot be flattened like a horseshoe. Malformed foot. Intra-foot (outer-foot) turnover is often caused by fetal foot pressure in the uterus and long-term abnormal posture, resulting in abnormal shape. There are genetic factors that belong to polygenic inheritance.

Foot varus deformity is a state of subluxation with the boat joint, which fixes the foot in an adducted and supinated position. Newborn babies have small heels on one or both sides, forefoot adduction, varus, increased skin texture on the inside of the foot, thinning of the lateral and dorsal side of the foot, and the heel cannot be flattened like a horseshoe. Malformed foot. Intra-foot (outer-foot) turnover is often caused by fetal foot pressure in the uterus and long-term abnormal posture, resulting in abnormal shape. There are genetic factors that belong to polygenic inheritance.

Visiting department

Pediatrics and Orthopedics

Multiple groups

Male newborn

Common locations

foot

Common causes

Congenital foot malformation

Common symptoms

Unilateral or bilateral foot ankle joint plantar flexion, varus, adduction deformity

Foot Inversion Overview

Most children are light, and the deformity and abnormal posture of the foot after delivery can be easily restored without treatment, and the prognosis is good. In severe cases, if you fix it in an abnormal posture, it will hinder walking. Children's health, intelligence, and life expectancy are generally normal.

Inversion of the foot

There are two types of congenital horseshoe foot deformities, internal and external. External causes are usually caused by abnormal fetal position in the uterus. This kind of child has no obvious severe soft tissue shortening after birth and is relatively easy to correct. The endogenous type often has similar patients in the family and is an autosomal dominant genetic disease. This type of deformity is severe and stiff, and the bony arrangement is abnormal.

Foot Inversion Imaging

The diagnostic criteria for foot varus deformity is that the ball of the plantar thumb and the long axis of the tibia and fibula of the calf are in the same plane. There is no uterine wall and placental compression or support around the foot. Changes, multiple scans show the same audiovisual characteristics. Those who have the technical requirements for three-dimensional ultrasound inspection can further perform three-dimensional imaging inspection to obtain more and more intuitive information. Under normal circumstances, the ultrasound scan showed that the plantar plane and the long axis of the tibiofibular axis were always perpendicular, and not on the same plane. When the subluxation of the scaphoid joint causes the foot to be varus deformity, the audiogram shows that the plantar of the plantar thumb and the long axis of the tibia and fibula of the calf are in the same plane. It can still be displayed on the same plane, and there is no support or compression of the placenta and uterine wall, that is, no external factors.

Foot Inversion

Treatment should begin as soon as possible after birth. Manual correction is applicable during the neonatal period. The manual corrective operation should be gentle. Fix the heel with one hand and correct the adduction of the forefoot with the other. Afterwards, correct the varus and horseshoe in turn. After the correction, fix it with tape to maintain the corrected position. The toe base and forefoot are padded, and the heel, medial malleolus, and knee joints should also be protected. Treatment takes about 6 to 10 weeks. For infants over 6 months, long leg plaster can be used to fix the position after correction. Changing the plaster once a month takes about 9-12 months. Fixation with plaster should pay attention to prevent bruises and impaired blood flow. The outer side of the heel of the sick child should be about 0.5 cm high to consolidate the effect.

Children 1 to 3 years of age can be treated with surgery. There are two main types of surgery:

(1) Soft tissue surgery

Including the extension of the Achilles tendon and incision of the ankle joint capsule to correct the foot and horseshoe deformity, the release of the medial soft tissue of the foot to correct the varus of the foot, the tendon transposition to maintain the foot muscle balance.

(2) Bone surgery

It is suitable for sick children over 10 years old, including various osteotomy and joint fusion of the foot to correct deformities and stabilize joints. Because there are many types of surgery for congenital varus varus, the effects are different, so doctors often have to make a choice based on the specific situation of the sick child.

The principle of surgery is to remove or loosen pathologically contractile soft tissues that all hinder orthopedics. Such as Achilles tendon extension, patellar fascia release and so on. In addition to the posterior medial soft tissue release, children 3 to 5 years old can also perform calcaneal osteotomy, calcaneal joint fusion, tendon transfer, and dice wedge osteotomy.

After 12 years of age, if you still have foot pain, dysfunction, and severe deformity, you can do three-joint fixation, and use short leg plaster for 3 months after the operation until the bone is healed.

Children with congenital horseshoe varus foot have poor dorsiflexion and valgus muscle strength. Tendon transplantation can balance muscle strength. The tendons available for transplantation are the tibialis anterior and posterior tibialis. The valgus muscle strength can also strengthen the back muscle strength. However, the clinical observation of the posterior tibialis anterior muscle defect is that the posterior tibialis muscle path is relatively short, and the surgical operation is complicated. The tendon fails after displacement; the posterior tibialis tends to show obvious foot valgus deformity after it moves forward. Therefore, we advocate the use of the tibialis anterior muscle to move to the third wedge, unless the tibialis anterior muscle group is completely paralyzed to reconstruct the dorsiflexion function.