Description, Causes and Risk Factors:
Valgus deformity is a term used in orthopedics to describe a condition in which a segment of a joint or bone is angled outward. The opposite of a valgus deformity is a varus deformity, in which a segment of a bone or joint is angled inward. The two terms, however, are often mistakenly interchanged. Such types of deformities are most often present in hips, knees, and feet. When necessary, these deformities can, to some degree, be surgically repaired.
Though they are often interchanged, the terms valgus and varus are always supposed to refer to the specific direction in which the distal segment in the joint is facing. The distal segment of a joint is the point farthest away from center of the spot where the separate bones physically join. In Latin, valgus means “knock-kneed” and varus means “bowlegged.” The modern names for these deformities were derived from these Latin terms. A valgus deformity always refers to a condition in which the distal point of the joint points outward, while a varus deformity always refers to a condition in which the distal point of the joint points inward.
There are several different types of valgus deformities depending on the specific joint that is deformed. In the hip, such deformities are known as coxa valga. Typically, the shaft of the femur is angled outward from the neck of the femur. Cubitus valgus describes a deformity in the elbow and results in turned-in elbows. In hallux valgus, the big toe points toward the second toe, and the joint point outward, away from the foot.
Valgus deformities can occur at several other joints and bones, such as the knees and ankles. A varus deformity can occur at the same variety of joints and bones that a valgus deformity can occur at. Without treatment, these deformities can place stress on other joints and bones and cause further problems. The main problems associated with a valgus deformity are pain and difficulty of movement. Successful surgery can partially or completely fix these problems.
Valgus deformity of the hindfoot is often seen in children suffering from spina bifida. It also occurs in various other neuromuscular disorders and in patients with congenital absence of fibula. In children with no neurological involvement of the lower limbs the valgus normally occurs at the subtalar level.
Other risk factors may include:
Osteomyelitis (bone infection).
Overweight or obesity.
Rickets (a disease caused by a lack of vitamin D).
Injury of the shinbone (only one leg will be knock-kneed).
Signs and Symptoms:
The anatomic deformity is usually larger in valgus than in varus, and it is on the femoral side.
Femur internally rotated, and tibia externally rotated.
Lateral orientation of tibial tubercle.
Vastus lateralis enhanced as a dislocating moment of force on patella.
Lateral and posterior contractures, medial stretchingtypically the lateral femoral condyle is deficient.
In valgus knee, ligament balancing is more difficult to fix.
A diagnosis is normally made by physical examination, during which flexionand extension of all joints in the wing can be both normal and abnormal.Sometimes there may be abnormal laxity in the joints and some subluxation ofthe tendon of the propatagium over the carpal area.
Treatment for a valgus deformity starts with assessment of the patient, which can include a physical exam and medical imaging studies. During the assessment, the doctor will determine the cause of the deformity, and develop a treatment plan. These deformities often require the attention of an orthopedic surgeon who can correct the deformity and apply a cast which will hold the bone or joint in place while it heals. There are various types of surgical procedures which are followed in treating this condition. Surgery may be considered for valgus that persist beyond late childhood and in which the separation between the ankles is severe.
Surgeries may include:
Osteotomy: It is the procedure, in which depending upon the severity of the condition a cut is made either at the base of the metatarsal bone or at the end of it for treating the condition. If the cut is made at the end of the metatarsal then it is known as proximal osteotomy and if it made at the end of the metatarsal then it is known as distal osteotomy.
Chevron osteotomy: In this process a screw is inserted which holds the bone in its position. It also helps in speeding up the healing process too. Once the surgery is carried out, the patient is allowed to wear surgical shoes just after the surgery. These shoes help in walking and also in early healing the bone. These shoes must be worn for 3-4 weeks after the surgery for best results.
Exostectomy: In this condition, the extended bone is simply shaved off. This is a temporary procedure and there are huge chances for the deformity to reoccur after certain duration of time.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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