Valgusstrateegiat

Valgusstrateegiat is a term used in Estonian orthopedic literature to describe a structured approach to assessment and correction of valgus deformities, where a distal limb segment deviates laterally from the proximal segment. Valgus deformities can affect the knee (genu valgum), ankle, or elbow and may be congenital, developmental, post-traumatic, or neuromuscular in origin. The strategy typically begins with clinical assessment and imaging, including full-length standing radiographs to measure angular axes and distinguish bony and soft-tissue contributors. Identified etiologies guide goals, such as relieving symptoms, slowing progression, or restoring alignment to improve joint mechanics and function.

Nonoperative management includes monitoring for mild deformities, physical therapy to strengthen hip abductors, quadriceps, and core muscles, activity modification, and bracing or shoe modifications to alter load. In children, guided growth with hemiepiphysiodesis devices may allow gradual correction.

When nonoperative measures fail or deformity is severe, surgery is considered. In knee valgus, osteotomies such as high tibial osteotomy or distal femoral osteotomy realign the limb by removing a wedge; in skeletally immature patients, guided growth can correct deformity over time. Foot and ankle valgus may be treated with osteotomies or soft-tissue balancing, depending on severity. In complex deformities, external fixation strategies (Ilizarov or circular frames) or staged procedures may be used. Choice depends on age, location and plane of deformity, and underlying pathology, as well as patient and surgeon goals.

Outcomes depend on timing, etiology, and rehabilitation; complications include recurrence, nonunion, or overcorrection. A well-structured valgusstrateegiat aims to restore alignment, optimize joint function, and reduce risk of later degenerative changes.