Some developmental abnormalities of the legs or feet (orthopedic disorders) can make it difficult for a child to move properly. In most cases, these anomalies are harmless and correct on their own as the child grows.

But in some cases, it is necessary to consult the doctors of the children's clinic (first of all, pediatric orthopedists, orthopedic traumatologists), who will prescribe the appropriate correction or treatment.

In young children, malposition of the feet is often manifested: turned in or out feet, flat feet, crooked feet.

The child's feet are turned inward

This anomaly appears when the child begins to walk. It can result from a twisted foot, twisting of the calf, or a misalignment of the femoral neck, where the entire leg turns inward. The child walks normally, but runs badly and often falls. In the vast majority of cases, this anomaly corrects itself as the child grows up. In the most difficult cases, a doctor (pediatrician) prescribes exercises to correct such a deficiency, based on a specific physical activity (for example, cycling). Sometimes it is prescribed to wear special tires at night.

The child's feet are turned outward

In most cases, when taking their first steps, the child imitates the gait of a duck. This shouldn't cause much concern. The mobility of the joints of his knees and feet is still too great to support his legs in the correct position. Over time, as the child's muscles strengthen, these joints become stronger. However, in some cases, this feature is associated with the twisting of the lower leg to the outside, which is often accompanied by flat feet. The doctor in this case should carefully consider whether there is a characteristic trampling of the sole in the area of ​​\u200b\u200bthe big toes. The anomaly in most cases is hereditary and, as a rule, gradually progresses, although the situation may improve somewhat with age. In difficult cases, surgery may be suggested.

Flat feet in children

In the normal state, the arch of the leg is arched and completely does not touch the ground. When a child has flat feet, the arch of the foot is weakened and the foot rests on the ground with the entire area of ​​the foot. Until the age of six or eight, every child's feet are a little flattened when they walk: their foot is covered with a small layer of lubricant, and the muscles and tendons are not yet very capable of resisting the impact of walking, maintaining the shape of the arch of the foot. Meanwhile, in a calm state, the foot should have a well-defined arched arch. In some cases, there is poor development of the arches of the feet, which may be a consequence of the curvature of the knees or a hereditary anomaly. Most often, flat feet do not interfere with the child, even when playing sports. But, if walking becomes difficult and pain occurs, consultation of a pediatric orthopedic doctor is necessary. He may recommend wearing special insoles or arch supports to support the arch of the foot.

Logo style development http://www.o-kvadrat.ru/ Crooked legs in children

Crooked legs of a child is a congenital defect that occurs in about one in a thousand babies. This deformity is caused by too short muscles and leg tendons. The leg is turned inward. The sooner corrective treatment begins, the more successful the result will be. Usually there are enough procedures to stretch the sore leg. If necessary, you have to resort to the use of tires. Treatment usually begins before the age of 5 or 6 years. In severe cases, surgery is required.

Orthopedic disorders in the knees and legs

Sometimes children's legs are not quite straight. The direction of the bend can be inward (crooked knees) or outward (curved legs).

Pain in the legs. Many children complain of pain in the legs that does not have an exact localization, especially after active movement during the day. These pains are associated with growth and can be attributed to tendon and muscle fatigue. If the pain is frequent and greatly disturbs the child, it is a good idea to consult a pediatric orthopedic doctor so as not to miss a more serious anomaly.

X-shaped legs when the lower legs and thighs are curved inward and form an angle open from the outside. Such a violation of the form appears at the age of two to three years due to weak muscle and tendon tone, and sometimes due to too much weight. The child waddle and often falls. The anomaly increases by 4-5 years, and then, in the vast majority of cases, disappears by 10 years. The doctor simply recommends regular monitoring and taking measures against excess weight (if necessary).

O-legs. This anomaly, usually harmless, appears at the time when the baby is learning to walk. It is most often associated with the position of the fetus during the mother's pregnancy. In most cases, no treatment is needed if there is progress in correcting the anomaly as the child grows.

New children's multifunctional polyclinic "Markushka".

The child turns the foot outward when walking

Right leg out (8m29d)

Alice can't walk on her own yet. But with pleasure and for a long time worth it. He also likes to walk leaning (holding) on ​​a chair, walker or .... finds other things to lean on and move.

(There, my beauty, she climbed into the rack, does the cleaning, brushes everything off the shelf, loves cleanliness and order like dad, mom always has everything everywhere and is "stored". I don't mind, (I removed sharp - piercing objects), in general I think this better than many toys, knows the world - so to speak)))))

Well, about the legs. When walking, the Fox turns its right leg outward, like a ballerina. I told this to my mother, she says I need to show the doctors. And in our city with doctors it’s tight, there are no doctors. Only ENT 2 times a week. Yes, that’s not even the point, I don’t want to dangle with a child in hospitals. Well, a healthy child, why do we need these "crowds" of bacilli. But thought about it. And here's the article I found:

The gait of children from one to two years is as different as their characters. Most begin walking with their feet turned outward, as this position improves stability. Then, when you start to worry about the outward-turning feet, the child replaces one concern with you for another and turns his feet inward. You can safely brush aside your mom's advice to take your child to an orthopedist. For most children, the legs and feet straighten on their own by the age of three.

Fingers inside. AT During the first two years of life, almost all children turn their toes inwards. This is due to two reasons:

The normal bend of the legs left after the fetus has been in the uterus.

Normal flat feet. The arch of the foot rarely develops before the age of three. To compensate, children turn their feet inward as they walk to form an arch and better distribute their body weight.

Here is a graph of the normal development of the feet and legs:

Varus knee (O-shaped curvature of the legs, "legs with a wheel") from birth to three years;

Turned out toes, like a ballerina, when a child begins to walk;

Inward-turned toes from eighteen months to two or three years;

Walking on legs turned straight after reaching the age of three;

Knee valgus (X-shaped curvature of the legs, "cross legs"), from three years to adolescence

If your child runs and doesn't stumble, don't worry about inward-turning feet. They must heal themselves. But if your child stumbles more and more, orthopedic treatment may be needed to

Almost all children under two years of age have their toes turned inward.

The latter is usually carried out starting at about eighteen or twenty-four months. (Treatment usually consists of a brace inserted between special boots to hold the feet in an everted position; the brace is inserted while sleeping.)

In addition to the inward rotation of the lower leg, which is known in medical science as inward tibia (i.e., the rotation of the largest bone of the lower leg), another reason for the toes to point inward is the inversion of the femur. Here's how to tell one from the other. See how your child is standing. If the kneecaps look straight ahead,

Rice. A. The position of the embryo during sleep.

Rice. G. Crossed Rice. D. With stretched forward

feet. feet.

eversion of the feet is more likely due to the rotation of the legs. If the kneecaps are facing each other, this is a rotation of the femurs.

If your child sleeps and sits in the correct position, you will reduce the risk of both deformities.

The saying “Bend the branch, so the tree will grow” definitely applies to children's feet. Don't let your baby sleep in the fetal position (Figure A). If the child can not be weaned from this position, sew pajama legs together.

Try not to let your child put his legs and feet under him when he is sitting: this exacerbates inversion of the tibia (see Fig. B).

Rice. B. Sitting position

with folded under

feet.

Rice. B. W-shaped posture.

To reduce femoral inversion, wean your child from sitting in a W-shaped position (Fig. B), and teach him to sit cross-legged (Fig. D) or stretching his legs forward (Fig. E) instead.

Flat feet. These flat-toothed feet probably won't stay that way for long. Usually by the age of three, the arch of the foot is formed. If flat feet continue after three years, treatment may or may not be required. Here's how to determine if flat feet represent a medical condition. Stand behind your child and watch him stand barefoot on a hard surface. Draw a line along the Achilles tendon or put a ruler down to the floor. If this line is exactly perpendicular to the floor, flat feet usually do not bother the child and no treatment is needed. If the line is tilted inward (called pronation), your child may be helped with orthopedic liners, plastic devices that fit into regular shoes. They support the arch of the foot and heel and align the bones of the lower leg (tibia and fibula) and the talus in one line. Although there is controversy, some podiatrists believe that treating a child with severe pronation with orthopedic inserts is about

age three and up to age seven can reduce leg pain and the risk of later bone and joint deformity.

Walking on toes. Most babies go through a period of toe walking between the ages of one and two, God knows why! As a rule, this is a habit or the child is just fooling around. If this habit persists, your doctor will need to examine your child's calf muscles and Achilles tendon to see if they are tight.

If the child is lame and walks strangely. It is very important to notice unusual features of your child's gait and report them to the doctor. Limping in a child should always be taken seriously and deserves a full medical examination. If your child walks strangely (for example, waddling like a duck or dragging one leg), report your observations to the pediatrician.

If the child does not want to walk. If your child, who used to walk perfectly normally, suddenly refuses to walk, which happens sometimes, tell your pediatrician. Pay attention to the following:

Can you remember anything that could have caused you to stop walking, such as an injury or fright after a recent fall? Record in detail everything that happened before the child went on a sit-in.

Conduct an inspection. Undress the child. Examine and feel his legs and feet for bruising, redness, swelling, and tender areas by applying gentle pressure to all bones, including those in the foot. Compare one foot to the other; move your hip, knee and ankle joints. Does the child wince in pain when you do this? Examine the soles of the feet and gently feel them for splinters or broken glass.

Is the child sick? Did he have an unexplained rise in temperature?

Have there been any traumatic events for the psyche recently?

Take the child (and your notes) to the doctor for a comprehensive examination.

Growing pains. The development of the organism does not cause pain, at least not physical pain. Most podiatrists consider growing pains, or growing pains, a myth. These pains invariably come on at night and wake up the child, who complains, "My legs hurt." These pains subside after a foot massage and disappear with age. I believe that in many cases these pains are due to muscle strains that have occurred

To determine if flat feet are a problem, look at the line

Achilles tendon when your child is standing on a hard surface. tilted

inward line (left) may indicate

need for orthopedic

liners; straight line passing

perpendicular to the floor plane (right),

usually indicates that no

treatment is not needed.

still during the day, while jumping and running without rest. In addition, I have observed children whose pain was relieved after orthopedic inserts were inserted into their shoes, which remove part of the load from the muscles of the legs when standing and walking, especially if the child has flat feet with pronation.

With valgus flatfoot in adults, treatment is an extremely complex, lengthy and complex process. In this case, therapy should primarily be aimed at strengthening the ligaments and muscle groups of the foot, as well as help eliminate pain. In some cases, this may require surgery.

What is a hallux valgus deformity?

Valgus flatfoot in adults develops as a result of a neglected course of a disease called valgus deformity of the foot. This pathology is a structural violation of the foot, in which its middle part is shifted down, and the heel and toes look outward. The displacement occurs due to the weakening of the ligamentous apparatus. With a neglected form and a prolonged course of the disease, stronger muscle groups, as it were, pull the foot to their side, and the process of development of flat feet begins.

This pathology is quite widespread. According to statistics, from 5 to 15% of the adult population suffer from valgus flatfoot. The disease causes discomfort and discomfort to patients, significantly reducing their quality of life. The most common symptoms of valgus flatfoot include the following:

1. Puffiness.
2. The development of a pronounced pain syndrome.
3. Leg fatigue.
4. Calluses.
5. Posture disorders.
6. Back pain.
7. The formation of calluses.
8. Rapid fatigue and discomfort when walking.
9. The presence of a cosmetic defect, expressed in an increase and a clear deviation of the joint.
10. Pain in the knee region.
11. Change in shoe size.
12. Redness and swelling in the joint of the thumb.
13. An increase in the size of the joint and its characteristic bulging.
14. Disturbances and changes in gait.
15. Pain in the lumbar region.

In addition, valgus flatfoot is invariably accompanied by diseases such as arthrosis of the metatarsophalangeal joint, chronic bursitis.

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What causes hallux valgus deformity?

The pathogenesis of hallux valgus and flat feet largely depends on the age category of the patient. So, among the reasons contributing to the development of the presented pathology in adults, experts distinguish the following factors:

1. Wearing uncomfortable shoes.
2. Frequent walking in high heels.
3. Overweight.
4. Consequences of various kinds of injuries.
5. Excessive or, on the contrary, insufficient physical activity.
6. hereditary predisposition.
7. Past poliomyelitis.
8. Rickets, leading to softening of the bone tissue.
9. Incorrect distribution of the load on the legs.
10. Hormonal changes (for this reason, flat feet are often observed in pregnant women).
11. Violations in the functioning of the endocrine system.
12. Frequent stressful situations.
13. Weakness of the muscles and ligaments of the foot, congenital or acquired.
14. Postponed fractures of the foot or ankle bones.
15. Prolonged stay in plaster.
16. Various types of ligament injuries.
17. Subluxation of the phalanx of the thumb.
18. Weakness of the tendons.
19. Gout of the joints, accompanied by increased accumulation of uric acid salts.
20. Infectious diseases accompanied by a violation of the process of blood supply.

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Who belongs to the risk group?

Despite the fact that flat feet are an extremely common problem that can occur at any age, experts will identify a group of people who are most susceptible to hallux valgus. These include women under the age of 30 and representatives of the following professions, whose activities are associated with a long stay in a standing position or increased trauma:

1. Fashion models and fashion models (this is mainly due to frequent and prolonged walking in high heels).
2. Teachers.
3. Sellers.
4. Workers working on machines.
5. Hairdressers.
6. surgeons.
7. Athletes involved in running and jumping.

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What is dangerous pathology?

Valgus flatfoot is fraught with the development of a number of rather severe concomitant diseases. In the absence of proper therapy, the foot gradually loses its spring and support functions. In the future, the pathological process extends to the entire musculoskeletal system of the patient, affecting the spine, hip, knee and ankle joints. The most dangerous and common complications of hallux valgus that are observed in adult patients include:

1. Arthrosis.
2. Phlebeurysm.
3. Scoliosis.
4. The development of pathologies of internal organs.
5. Headaches.
6. Joint damage.
7. The appearance of the so-called heel spurs.
8. Finger deformity.
9. development of the diabetic foot.

It should be emphasized that in many cases the pathological process of foot deformity can lead to irreversible changes, the result of which will be the absolute impossibility of movement and disability of the patient. Therefore, if you find the above signs, you must urgently seek medical help and begin treatment. After all, the sooner the therapeutic course is started, the more likely it is to achieve favorable results.

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Features of the treatment of hallux valgus in adults

Valgus flatfoot in children is quite easily amenable to therapeutic effects, but the treatment of pathology in adults is a rather complicated, lengthy and laborious process. What is it connected with? The fact is that bone tissue and joints in childhood are soft and elastic, and therefore their correction for a specialist is not difficult, especially in the case of a timely visit to a doctor.

As for an adult, his foot is already fully formed, the bones and joints are hard, lack elasticity and practically do not lend themselves to any changes, which greatly complicates the treatment process.

In this case, therapy should be mainly aimed at eliminating painful symptoms, increasing muscle tone and strengthening the ligaments of the foot, preventing the development of possible complications and the development of concomitant diseases. The main task of the specialist is to stop or ultimately slow down the development of the pathological process and prevent its influence on the entire musculoskeletal system of the patient.

Methods of dealing with valgus flatfoot in adult patients largely depend on the severity and duration of the course of the disease. So, if the patient turned to a specialist in the early stages of the development of pathology, then they try to treat it with the help of conservative therapy. The following methods are used for this:

1. Massages and hydromassages.
2. Wearing orthopedic shoes and using orthopedic insoles.
3. Physiotherapy.
4. Physiotherapy.
5. Myostimulation of the ankle muscles.
6. Wearing plaster orthopedic bandages.
7. Acupuncture.
8. Drug treatment, which consists in taking painkillers, as well as medicines that help eliminate swelling and relieve tension in the legs.
9. The use of special night bandages.
10. thermal procedures.

However, in most cases, for the treatment of valgus flatfoot in adults, it is necessary to resort to surgical treatment, especially if the disease is in an advanced stage with the presence of concomitant complications.

Surgery is a procedure to replace damaged ligaments of the foot with artificial implants, which contributes to the restoration of its arch. It is possible to use the method of osteotomy - surgical reconstruction of the foot bones.

Often people complain of growths in the leg area, which look more like bones and interfere with movement. These bony bumps are called hallux valgus. Such a bump on the foot prevents you from wearing any shoes, causes severe pain. This outgrowth does not look at all aesthetically pleasing and is a certain pathology that requires mandatory treatment, wearing special shoes and following recommendations. In especially advanced cases, the pathology requires surgical intervention, without which the patient's life becomes really difficult.

Characteristics and causes of the disease

Valgus deformity of the foot in adults looks very depressing. These are feet that seem to fall inward. The heels are separated by an impressive distance (more than four centimeters) with the legs brought together and straightened. The feet themselves flatten and when walking there are exceptionally unpleasant sensations.

The pain can be expressed not only in the region of the bone, but also on the ankle and even affect the femoral neck. The flat-valgus sole forces a person to change his gait in an attempt to get rid of the ubiquitous pain and “accommodate” to the current situation.

For the curvature of the foot, the root causes can be a variety of circumstances:

• Violations of the development of limbs inside the womb at different stages of pregnancy.
• Wearing poor-quality wrong shoes in childhood.
• Connective tissue dysplasia.
• An endocrine or other serious hormonal disease that has arisen.
• Complicated, untreatable metabolic disorder.
• Paralysis, paresis, osteoporosis and other diseases.
• Violation of posture, constant wearing of high heels and uncomfortable shoes.
• Pregnancy and postpartum period up to six months.
• Being overweight, which puts a lot of pressure on the bones.
• Fractures, ruptures of ligaments and their tears, cracks in the bones.

There may be other reasons that the doctor can establish after examining and studying the medical history.

The presence of the disease in preschool childhood speaks of improperly selected shoes, which destroy the proper development of the foot from an early age. Too strong physical activity, illiterate distribution of physical exercises - act as destructive as the lack of load. At an older age, it is necessary to monitor the possible development of flat feet and changes in the foot, not only in case of injuries and chronic diseases, but also “on an ongoing basis”.

With valgus, a certain x-shaped curvature is formed. The inner edge of the heel rests on the surface. At the same time, the bone near the big toe begins to bulge into the inside of the foot. Most often, the defect is accompanied by flat feet.

Risk group

The most susceptible to the disease in question are people who, by the nature of their profession, spend most of their time on their feet: dancers, models, sellers, surgeons, hairdressers, teachers.

People who categorically cannot move away from the workplace to rest are forced to stand for hours. Attempts to change the situation are accompanied by a deterioration in the results of their work. The hairdresser will get the wrong shape of the hair that is needed, and the teacher will get out of control most of the class. Sellers not only spend almost the whole day without the opportunity to sit down, but also often carry weights, which also affects the deformity of the legs. This category also includes models, fashion models and dancers. They have to spend up to twenty hours a day on their feet, often in high heels or simply uncomfortable shoes.

There are people who are more susceptible to the manifestation of the disease than others. Despite the fact that such a common phenomenon as flat feet can occur in any person, there is a category of people who are more likely to have hallux valgus.

Relieve pain sensations

The first thing to do to get rid of or reduce pain is to check the shoes. Most likely, it is inconveniently shaped or made of low-quality material. In this case, it is necessary to change shoes, which will help relieve most of the tension and discomfort. In comfortable and comfortable shoes, pain will be much less or disappear altogether.

When the bone becomes pronounced, then changing shoes will no longer help. This signals the beginning of the inflammatory process, which must be removed. Helps to cope with discomfort:

• Massage of the inflamed area.
• Use of anti-inflammatory ointment.
• Special gymnastics, both for prevention and to relieve discomfort.
• Use of non-steroidal anti-inflammatory drugs. Without a doctor's prescription, their use is highly undesirable.

It often happens that before you go to a doctor who will prescribe the right treatment, you must first remove the pain. For this, both folk remedies and medications are used.

Treatment at various stages

The orthopedist prescribes various diagnostic options, including such procedures as plantography and podometry. Only on the basis of these data, he will be able to make a correct diagnosis of valgus deformity of the foot in adults, prescribe treatment depending on the established degree.

Foot valgus in adults can be one of three different degrees of severity:

1. First degree. There is no pronounced deformation of the foot, the patient moves easily and feels good. However, when walking for a long time, he begins to experience strong pain and deforming sensations. This is one of the first warning signs that requires a response and preventive action that will relieve the development of foot disease.
2. Second degree. Outwardly, the shape of the foot begins to differ, but not critically. A small outgrowth is visible, and the bone is enlarged. Choosing shoes becomes problematic. If you react at this stage, then the treatment will consist of massages, baths and compresses with herbs, special exercises and orthopedic shoes, the foot becomes almost flat. If you do not react, the disease will go to the last stage.
3. Third degree. The leg looks extremely unaesthetic, it does not take on a natural shape. The outgrowth and bone near the thumb are strongly pronounced, and the finger itself is not evenly located and deformed. Pain haunts every time you try to walk, and picking up shoes is almost impossible. But even in soft, non-pressing shoes, there is obviously a problem. At this stage, conservative treatment is no longer advisable, so surgery is most often used. And to the question: how to treat hallux valgus at this stage, any doctor will answer - only in a hospital. The intervention itself is a complex operation with a difficult postoperative period. In not the most advanced cases, they first try to cope with the disease with a set of measures usually used in the diagnosed second stage.

If you notice an unusual protrusion of the big toe bone, you should consult an orthopedic doctor. It is he who examines the foot and, if necessary, sends for an x-ray.

Surgical method

The deformity of the legs can be in such a neglected state that it is no longer possible to do without surgical intervention. The patient is only trying to stand on the foot, and is already experiencing terrible pain, the bone reaches a serious size. As a result, even when trying to put on shoes, a person cannot cope and is forced to stay at home in a sitting or lying position.

The recovery period after surgery is not the easiest and fastest. It lasts about one and a half months, during which the patient is required to attend rehabilitation therapy. This period is difficult and painful, but it cannot be compared with what it was before the operation. After all, before the operation, as a rule, a person was not able to walk to the ward himself and put on slippers.

During surgery, doctors make a small incision and put the bone in place. Then they cut off excess growths and clean the body cavity from them. Next, specialists fix the metatarsal bone in the appropriate place for it and sew up the incision with special strong threads.

Surgical intervention is considered the most cardinal method of treating hallux valgus deformity of the foot. Surgeons try not to use it unless "extremely" indicated, and patients are reluctant to agree until the pain starts to drive them crazy when they try to take a step.

Lack of treatment and pathology

In addition to pain, which will eventually become a constant companion of the patient and will interfere with walking, the opportunity to pick up comfortable shoes will disappear.

- a defect characterized by a decrease in the height of the arches of the foot and an X-shaped curvature of its axis. With hallux valgus, there is an outward turn of the toes and heels, drooping of the midfoot, clumsiness of the gait, increased fatigue, and pain in the legs. Valgus deformity is diagnosed by a pediatric orthopedist on the basis of an external examination, radiography of the feet in 3 projections, plantography, podometry. Treatment is carried out with the help of exercise therapy, massage, wearing orthopedic shoes, applying orthopedic splints; in case of ineffectiveness, surgical intervention is performed.

General information

To exclude the pathology of the central and peripheral nervous system, children should be examined by a pediatric neurologist.

Treatment

The goal of the treatment of hallux valgus in children is to restore its normal shape and function, to strengthen the muscular and ligamentous apparatus.

With congenital hallux valgus, immobilization of the limbs with plaster casts may be necessary. The selection and modeling of the dressing is carried out by a pediatric orthopedist, taking into account the type of deformation and the degree of deviation from the norm.

At the next stage (and in the case of acquired hallux valgus - from the very beginning), foot baths, massage courses (lumbosacral region, leg joints, feet), paraffin therapy, ozocerite and mud applications, electrophoresis, diadynamic therapy, magnetotherapy, electrical muscle stimulation are recommended shins and feet, IRT. Useful classes in therapeutic swimming and exercise therapy.

Children with hallux valgus need the selection of individual functional insoles or special orthopedic shoes with rigid lateral fixation of the foot and heel, arch support.

Surgical treatment is used relatively rarely (in about 7% of cases). The method of correcting valgus deformity of the feet is determined individually, taking into account the characteristics and severity of the pathology. The most widespread in pediatric orthopedic traumatology are methods of transplanting the tendon of the long peroneal muscle to the inner edge of the foot with lengthening of the Achilles tendon; arthrodesis of the talonavicular joint, application of an external fixation device, etc.

Forecast

Valgus deformity of the foot in children can reach severe degrees, being not only a pronounced cosmetic defect, but also causing functional disorders of the limb, up to disability at a young working age. In the case of a low degree of deformity and timely treatment, complete restoration of foot function is possible.

Prevention

In order to avoid the development of hallux valgus in children, the load on the lower limbs of the child up to 7-8 months should be excluded. It is necessary to adhere to a rational regimen, including hardening, gymnastics, preventive massage, good nutrition, sufficient sleep and walks. Important is the prevention of rickets, the intake of vitamin D and trace elements.

It is mandatory to regularly visit a pediatrician, as well as preventive examinations carried out by specialists in various fields (including a pediatric surgeon and an orthopedist). It is necessary to pay serious attention to the correct selection of shoes for a child: they must be in size (not small and not large); made from high quality natural materials; have a dense arch support, rigid back and side parts.