Is it possible to correct crooked legs? Crooked legs in a one-year-old child, causes and treatment. Exercises to eliminate leg defects

– a pathological condition in which the legs are bent at an angle that is open inwards. Typically, this pathology occurs due to an arched or, less commonly, angular curvature of the legs, resulting from congenital malformations or diseases characterized by decreased strength bone tissue. Accompanied by compensatory deformation of other departments lower limbs, especially stop. The diagnosis is made based on examination, radiography, CT, MRI and other studies. Treatment can be either conservative or surgical.

ICD-10

M21.1 Varus deformity, not elsewhere classified

General information

Pathanatomy

Normally, all newborns have a slight arched curvature of the legs (up to 20 degrees), due to the intrauterine position of the fetus. In this case, the child’s legs are symmetrical, but the shape and position of the feet may be asymmetrical. By the age of 2, the O-shaped deformity disappears and is gradually replaced by an X-shaped (valgus) one. A slight valgus curvature of the legs (up to 15 degrees) persists for up to 3 years, and then begins to decrease and by the age of 8 does not exceed 7-9 degrees. Subsequently, both the complete disappearance of the curvature and the preservation of a slight residual angle are possible.

Varus curvature, which persists beyond the age of 2 years, is a cause of abnormal development of the knee joints. The external condyle of the femur increases, the internal one decreases. The joint space becomes uneven - narrowed inside and widened outside. The inner meniscus is compressed, the ligaments along the outer surface of the joint are stretched. Initially, the feet take a flat-varus position, their anterior sections and heels deviate inward. Subsequently, a compensatory flatvalgus deformity of the feet is formed. In severe cases, the tibia rotates inward and the hips rotate outward. Flexion in the knee joints is limited. Gait disturbances and rapid fatigue when walking occur. Due to a shift in the center of gravity, load redistribution and other pathological changes, children with O-shaped legs change their posture, and sometimes develop curvature of the spine (kyphosis or scoliosis).

Causes

The cause of unilateral O-shaped deformity in infancy is usually congenital hypoplasia caused by neurofibromatosis or fibrocystic dysplasia of the tibia. In contrast to physiological varus curvature, with this pathology, uneven deformation is observed (one lower leg is more curved than the other). The outcome of congenital hypoplasia of the leg bones can be pseudarthrosis.

Traditionally, one of the first places on the list of causes of O-shaped legs is rickets. And although this pathology is quite rare in pediatrics these days, it can occur, so it should always be excluded during differential diagnosis. It should be taken into account that rickets can develop in three periods of a child’s life: in utero (that is, to be congenital), in early age and in teenagers. The cause of fetal rickets is vitamin D deficiency in the mother. Currently, this pathology is detected mainly in economically disadvantaged countries.

Infantile rickets occurs after stopping breastfeeding. At this stage of development, the child’s body requires a large amount of vitamin D. If the baby does not receive this vitamin in sufficient quantities, his bones become insufficiently strong and gradually bend when walking. An O-shaped curvature of both the legs and hips is possible. In some cases, an asymmetrical deformity is observed: varus curvature on one side is combined with valgus curvature on the other side. Anterior bending can also form - the so-called saber shins. Moreover, in contrast to damage to the legs with syphilis, when the legs are bent only anteriorly, a combination of deformation in the lateral and anteroposterior directions is observed.

Another critical age at which the likelihood of developing rickets increases is the period of intensive growth in adolescents. The cause of the deformation is a lack of exposure to the sun, a deficiency of vitamin D in food, unfavorable living conditions and some diseases. There is persistent late rickets, which, unlike regular form disease, does not respond to treatment with standard doses of vitamin D. Persistent rickets develops due to genetic predisposition, chronic kidney disease and steatorrhea.

Intestinal rickets (rickets with steatorrhea) can occur with any type of long-term intestinal disorder. Occurs due to impaired absorption of fats, vitamins, phosphates and calcium. Similar disorders can be detected in adults, but in the latter case What is observed is not rickets, but osteomalacia. The cause of the development of renal rickets is chronic kidney diseases that interfere with the retention of phosphates and calcium in the blood serum. With renal rickets, it is more often observed hallux valgus, however, an O-shaped curvature is also possible.

Another reason for the formation of O-shaped legs is Blount's disease (deforming osteochondrosis tibia). With this disease, there is not an arched curvature, as with rickets, but an angular curvature of the leg with the apex of the deformity at the level of the proximal epiphysis. At an early age (2-4 years), with Blount's disease, as a rule, bilateral curvature is detected; at an older age, only one lower leg may be curvature.

In adults, O-shaped legs can form due to Paget's disease (osteitis deformans), accompanied by damage to the femur and tibia. It is possible to damage both several and one bone, but more often several bones are involved in the process. The curvature is caused by excessive growth of bone tissue with insufficient destruction. In this case, the newly formed bone does not have sufficient strength due to incomplete calcification. It thickens and at the same time becomes soft, resulting in curvature and transverse fractures.

Diagnostics

Depending on their age, an adult orthopedist and a pediatric orthopedic traumatologist can diagnose patients with O-shaped legs. The most important task when examining patients with O-shaped legs is to identify the underlying disease that caused the deformity. When making a diagnosis, the clinical picture, features of the curvature, the age at which the first symptoms appeared, heredity and the condition of other organs and systems are taken into account. All patients with O-shaped legs are prescribed radiography of the legs. If there is concomitant deformation of the upper limbs, an additional x-ray of the hips is performed; if compensatory changes in other parts of the limbs are suspected, x-rays of the hip joints and x-rays of the feet are performed.

To exclude rickets, the levels of alkaline phosphatase, phosphorus and calcium are studied in blood tests. If persistent forms of rickets caused by kidney and gastrointestinal diseases are suspected, the patient is referred for consultation to a nephrologist and gastroenterologist. To exclude Blount's disease and Paget's disease, radiographs are examined, and if necessary, MRI and CT scans of the legs are additionally prescribed. To identify hereditary predisposition, family history is studied in detail.

Treatment of O-shaped legs

At an early age, patients are prescribed complex conservative therapy. Exercise therapy, massage, individual orthoses and specially made orthopedic insoles are used. According to indications, treatment of the underlying disease is carried out. It should be borne in mind that correction of O-shaped deformity without eliminating its causes may be ineffective and in some cases even leads to the progression of the curvature, the formation of false joints, etc.

In adults, only surgical correction of the shape of the legs is possible. Usually, for O-shaped legs, a corrective osteotomy is performed in combination with the application of an Ilizarov apparatus. Incomplete osteotomy (dissection of the bone only along the inner surface) is used for true O-shaped curvature and a favorable distribution of the soft tissues of the lower leg from an aesthetic point of view. In other cases, a complete osteotomy is used. Depending on the magnitude and nature of the deformation, both immediate and gradual elimination of the curvature is possible. In the first case, the patient's legs are immediately brought into correct position, in the second, the relative position of the fragments is corrected by gradually “unscrewing” the nuts and increasing the distance between the rings with inside. IN postoperative period Exercise therapy and physiotherapy are prescribed. Usually it takes about 2 months to correct the shape of the legs, but with severe deformities this period may increase.

The beautiful shape of legs has long occupied the minds of all women. And male, of course! They are the standard of beauty along with thin waist, luxurious hair and healthy skin. Girls who have crooked legs are quite shy; they do not allow themselves to wear short skirts, they feel constrained on the beach or in the pool, and cannot fully liberate themselves in male society.

As soon as ladies realize that they don’t have perfect legs, they immediately start digging through the Internet and looking for photos of “those ones.” But don’t worry if your legs don’t meet the standards; there are many factors that influence their structure: age, gender, race. Let's look at what classification of lower extremities exists, how to properly hide leg imperfections, and also give a few useful tips how to fix crooked legs.

What kind of straight legs are they? There is a basic rule by which it is determined perfect shape: contact in 4 places. The photo below shows that these are the following points:

• mid thighs;
• mid-calf;
• knees;
• heels.

If these parts touch each other in the indicated places, then the girl has beautiful legs, and she can safely wear dresses of any length! With various deviations from this rule, it must be said that there is curvature of the legs, which is divided into the following types, their photos are given below:

1. if only the heels touch, and there is a kind of gap in the area of ​​the knees and shins, then this means that the lower limbs have an O-shaped curvature;
2. if the only point of contact is the knees, we can talk about an x-shaped curvature. With this shape of the legs, the ankles are spread apart.

Based on the classification of deviations, types of curvature are determined.

False curvature of the legs

It does not depend on bone formation. This is exclusively a feature of the formation of the soft tissues of the lower extremities; usually deviations are visible in the thighs and lower legs. Bad things are often said developed muscles or non-standard attachment of the calf muscles. If a girl wants to correct such crooked legs, then just go through the complex special exercises. After some time, the fair sex will be able to wear any miniskirt without embarrassment!

The true curvature of the legs depends on the structure of the bone skeleton itself. In this case, only surgical intervention can correct the shape.

How can you independently determine the structure of your legs?

There is a simple test to determine the curvature of the lower extremities, thanks to which at home you can determine whether your legs are crooked or not:

1. you need to stand exactly in front of the mirror: knees and heels are closed, toes are spread slightly to the sides;
2. check: if all the above 4 points are in contact and there are no gaps between them, then we can safely talk about ideal legs;
3. if, with the feet tightly closed, the knees do not close, but a deformation in the shape of the letter O is formed, then we speak of an O-shaped curvature;
4. and if, on the contrary, with the knees closed, the feet are spread apart, then an X-shaped deformity is present.

For what reasons is deformation possible?

In addition to searching the Internet for photos showing crooked legs, girls ask questions: why did the shape of the legs suddenly become deformed? There are several main points due to which ideal legs become crooked, to avoid this you must adhere to the basic rules:

1. try to ensure that the body weight is never concentrated on one leg, do not sit for a long time in a cross-legged position;
2. on rare occasions, wear shoes with very high heels, the right shoes will be able to correct this deficiency;
3. never stand on one leg, because it can bend under the weight of its own body;
4. give up the habit of putting your socks inside, such a seemingly harmless position can seriously deform your limbs;
5. if a woman often carries a heavy bag on one shoulder, this can also deform the shape of her legs and spine;
6. If a woman’s favorite sleeping position is on her side, then it is better to abandon it. Experts come to the conclusion that this position bends the legs over time.

How to avoid surgery?

Naturally, any girl who does not have perfect legs wants to know how to hide crooked legs or correct their shape without lying on the operating table. If the curvature of the legs is insignificant, then it can be hidden with the right clothes, but if the crooked legs are very “conspicuous”, then special corrective exercises will help to get out of the situation.

Here is a set of similar exercises:

1. Stand on the floor with your feet shoulder-width apart, now rise on your toes, trying to reach as high as possible.
2. An old exercise - cycling - can perfectly correct leg deformities. Lying on the floor, spin imaginary pedals for a couple of minutes.
3. The next exercise is scissors. Lying on the floor on your stomach, lift your legs off the floor by 20-25 cm.
4. The funny frog pose will also help make your legs straight; to do this you need to squat down, spreading your legs as wide as possible. You need to sit in this position for about 5 minutes, and over time, increase the duration of the interval to 20 minutes. Enough difficult exercise, which perfectly strengthens the muscles of the thighs and lower legs.
5. An excellent exercise for the hips would be the following: you need to lie on your side and lift the leg that is in contact with the floor, holding it for at least 20-25 seconds. Then you need to turn to the other side and repeat with the other leg. If you feel that one leg is weaker than the other, then it needs to be given more load.
6. Don’t forget about daily stretching of the thigh muscles; the following pose is perfect: standing on the floor, bend your knee and bring your heel to your buttocks, stand like that for about a minute, then move to the other foot.

In addition to a set of exercises, daily jogging, simple squats, and exercises on an exercise bike will help correct the curvature of the lower extremities. All exercises must be done on a regular basis. If you resort to them from time to time, there will be no result.
If physical exercise do not help get rid of this physical defect, then without expensive surgical intervention not enough. In this case, leg correction using the Ilizarov apparatus, cruroplasty, will help. These operations are quite complex and require strength, patience and a fairly impressive amount of money.

Selecting a wardrobe

Almost any imperfections in your figure or body structure can be hidden with the help of clothing. If you wear the right things, people around you will never notice your uneven legs. On the Internet or glossy magazines you can always find photos of a wardrobe specially created for the fair sex who have problems with bowed legs. Here's what's ideal for those who want to hide this physical defect:

• Maxi skirts will always cover uneven legs, especially now they are at the peak of fashion. It is better to choose skirts made of dense, high-quality fabric that will not deform when walking. And in order to distract the eyes of others from your legs, you can make a bright accent on the belt and bright jewelry.
• But under no circumstances should you wear skirts that reach mid-calf; such a cut will immediately emphasize their curvature.
• For girls with uneven legs, wide-leg trousers or straight-cut or loose-fit boyfriend jeans are perfect.
• You need to avoid jeans with bleached stripes and avoid vertical or bright patterns.
• You shouldn’t give up on capri pants, just remember to keep them loose below the knee.
• Boots with a wide top will help to hide the lack of legs perfectly, but these should be soft leather or suede shoes.
• If your legs are quite full, you can afford heels, but girls with uneven and thin legs are better off forgetting about heels.
• Thick, plain tights will ideally hide the deformation, but a large abstract pattern will draw unnecessary attention to your legs.

If nature has not awarded a woman with perfect legs, then this is not a reason to be upset and withdraw into herself. You can always find a way out of the situation, do various exercises, hide the curvature with the right clothes, because almost any defect can be hidden or corrected, if only you wish!

Many parents wonder at what age the curvature of a child’s legs can become an alarming sign, what degree of curvature can be considered an acceptable norm?

Ideally, when straightening the baby's legs, the inner sides of the ankles and knee joints should come together. But to a certain extent, the curvature of the legs in a small child is a physiological norm.

Causes of curvature of legs in children

A newborn baby has crooked legs, because for a long time he was in the mother's womb in a compact position. Over time, this curvature disappears because there are no longer obstacles limiting freedom of movement. Then the child begins to make independent attempts to take an upright position and walk. The skeleton of a small child is still very plastic, and the load on cartilage, ligaments, and muscles increases. Until the child’s musculoskeletal system has adapted to the new conditions, the legs may become slightly bent.

Until about one year of age, the child has an O-shaped curvature of the legs, and the child is slightly clubfooted. By the age of three, the legs can take on an X-shape, that is, when the knees are brought together, the feet are spaced a considerable distance from each other. The reason for this is the weakness of the muscular and ligamentous apparatus. Often the provoking factor is the child's excess weight. By the age of five, the curvature of a child’s legs usually evens out.

In any case, it is necessary to discuss the curvature of the child’s legs with a doctor. A pediatrician or orthopedist should monitor whether the curvature of the legs is a consequence of diseases and prescribe therapeutic measures to get rid of the defect.

Among the diseases that cause bowed legs, the most famous are rickets and Blount's disease.

Blount's disease is congenital and appears at approximately 2–3 years of age. Damage to the cartilages of both legs leads to curvature. In the early stages, I use plaster casts, massage and exercises for treatment; in the later stages, surgery.

IN childhood It is quite possible to correct crooked legs using conservative methods.

• When rickets is detected, the first step is to combat the lack of vitamin D by taking medications prescribed by the doctor. Most often, doctors prescribe vitamin D3 preparations;
• Additional classes are scheduled physical therapy, massage, physiotherapeutic procedures to strengthen the muscular system and skeletal system;
• Normalize the child’s daily routine, ensuring proper rest and walks. fresh air;
• If by the age of 2–3 years the legs do not straighten, then plaster casts can be used.

Foot massage

It is necessary to carry out therapeutic massage at least four times a year in courses of 15–20 procedures. If it is carried out by a specialist, then this is an extremely effective method.

1. With an O-shaped curvature, the knee joint has abnormal development. On the inside, the ligaments spasm, and on the outside, they stretch. During the massage, the lower leg external sides They massage more intensely, since the muscles there are stretched and weak. The inner side should be massaged easily; stroking is used to relieve tension. To correct the knee joint itself, when performing a massage, press on it from the outside.
2. With an X-shaped curvature, the opposite picture can be observed. The ligaments are in spasm on the outside. Therefore, they try to relax the muscles of the thigh and the outer surface of the lower leg, and strengthen the inner ones. An X-shaped curvature is more difficult to treat and can only be corrected before the age of three.

In addition you can at home Give your child a light massage yourself. To do this, the baby is placed on his back and stroked and rubbed from the toes and feet towards the knee. Then kneading movements and light pats are made in the same direction. With an X-shaped curvature, movements are performed on the inside of the leg, with an O-shaped curvature, on the outside.

Treatment according to Komarovsky

Serious diseases that can lead to bowed legs are, as a rule, rare congenital pathologies associated with impaired metabolism and absorption of calcium and phosphorus, for example, kidney disease, in which they cannot retain calcium in the body.

Dr. Komarovsky believes that a child should not be forced to sit and walk; the later he begins to assume a vertical position, the stronger his legs will be and the straighter his back will be. The child should only be encouraged to crawl. If the child is healthy, and the only thing that worries the parents is the curvature of the baby’s legs, then most often we are talking about hereditary anatomy.

If the clinical picture really corresponds to rickets, and laboratory tests have confirmed it, treatment is necessary.

In infants, rickets is treated with cholecalciferol in a daily dosage of 2000-4000 IU. After the symptoms disappear, the dose is reduced. If rickets is caused by impaired absorption, then the dose of the drug is significantly increased. Sometimes calcium gluconate and potassium phosphate are introduced into the diet to help cholecalciferol. The dosage is determined by the doctor.

During treatment, monitoring of calcium in the blood and urine is necessary.

Surgical correction of curvature of the legs is performed in extremely rare cases: if before the age of 3-4 years it was not possible to solve the problem of curvature, when one leg is shorter than the other, when the curvature interferes with walking or is a consequence of trauma. In all other cases, with the help of taking vitamins, massage and gymnastics, it is quite possible to straighten the child’s legs.

In 2001, the leading Russian orthopedic surgeon, Doctor of Medical Sciences Alexander Artemyev, developed the most popular classification of leg shape today, which is generally recognized and is used as the basis in methods of correction of the lower extremities.

In addition to classification, Dr. Artemyev introduced such terms and concepts as ideal legs, their true and false curvature.

What do these concepts mean, how to correct crooked legs at home? How to determine your shape? Find out the answers right now.

The beauty of legs is a concept that everyone builds on personal aesthetic perception. Just beautiful, that's all, you say. But it turns out that ideal legs exist, and their shape is calculated mathematically.

They should reach a length of up to 55% of your height, and it is also necessary to maintain certain proportions between body height and the volume of the hips and ankles. But the main thing is the straight line rule: if you draw an imaginary straight line from the middle of the thigh through the closed knees and ankles, then along the smooth inner contour of the limb three gaps will be visible: from the perineum to knee joints, under the cramped knees to the calves and from the calf muscles to the ankles. In front of you are perfect legs. But not everyone has been blessed with such things by nature. Anthropometric cosmetology deals with the correction of such defects.

The legs of many men and women are characterized by curvature, varying in severity and divided into two types - false and true. What is it and what is their fundamental difference?

1. True This curvature is the result of anatomical features or deformation of the skeletal bones of the femur and tibia. The lower limbs seem to form an arc. The cause of true, that is, bone curvature, is most often hereditary genes or diseases suffered at a young age, for example, rickets, or metabolic disorders. 2. False This kind of curvature is a disproportionate distribution of the soft tissues of the thigh and lower leg with an even, without defects, position of the skeletal bones. We can say that false curvature is the appearance of curvature in its real absence.

Types of true curvature and methods for determining them at home

True curvature is divided into two types:

O-shaped or varus

People with such bone deformities are said to have legs like wheels or like a football player. Wherever the discrepancy begins - from the level of the hip or the area below the knee, the shape of the legs will still end up looking like the letter “O”. The knees will “fall out” of the three ideal points of contact - they will not close with such a deformation. X-shaped, or valgus In this case, the knees, on the contrary, close tightly, but the ankles cannot come together. As a result, the shape of the lower limbs resembles the letter “X” and such people are said to have “X” legs.

We offer simple mini-test:

1. Stand straight in front of the mirror, bend one limb and observe the kneecap of the straight supporting leg. If it is displaced inward, you have an O-shaped deformity; if it is displaced outward, you have an X-shaped deformity.
2. Place your hands on your belt and do a simple squat at a slow pace. Watch your knees: with an O-shaped curvature, they tend to the sides, with an X-shaped curvature, they want to connect, if the legs are straight, they bend parallel to the feet.

An x-ray will help to finally put an end to this issue. She will not be deceived by false curvature - in the picture the axis of the leg, no matter what impression the disproportionately distributed muscles make, will be straight.

It must be said that distortion of the lower extremities is not only a problem of aesthetics. This can harm your legs and back. But today, almost any curvature can be straightened and leveled - it can be done independently or using special techniques.