Varus & Valgus Control in AFOs | varus vs valgus foot

A Varus/Valgus position is determined by the distal part being more medial or lateral than it should be. Whenever the distal part is more lateral, it is called valgus. Whenever the distal part is more medial, it is called varus. Therefore, when the apex of a joint points medially, the deformity, if any, would be called valgus, as the distal part points laterally.

It is important to bear in mind that the most proximal part of a bone or joint is the reference point and that varus and valgus angles are relative to the angle in a normal situation, which need not be zero.

When looking at lower extremity joints of the body, you can identify varus or valgus alignment by looking at knee alignment.

A varus knee is where the foot in relation to the knee is angled inward for a bowlegged presentation. This varus deformity shifts the axis medially which can cause more force and weight bearing on the medial part of the knee and specifically, the medial meniscus and medial collateral ligament. 

A valgus knee is where the foot in relation to the knee is angled outward for a knock-kneed appearance. This valgus alignment shifts the axis laterally which can cause more force and weight bearing on the lateral part of the knee and specifically, the lateral meniscus.

The most efficiently positioned knee or ankle is one that has its load-bearing axis that is perfectly aligned down the middle of the leg. Looking at varus or valgus deformities in lower extremity parts of the body, the malalignment caused by these deformities of the weight bearing axis can have detrimental effects. 

Overtime, severe cases can lead to many X-ray’s and MRI’s that can potentially spiral into aggressive approaches in the form of surgeries. Osteotomy is an orthopedic procedure in which bone is cut and then realigned. Another potential risk for valgus deformities is total knee arthroplasty (TKA). 

Varus or valgus knees or ankles can put you at high risk for osteoarthritis of the knee or ankle. Osteoarthritis occurs due to cartilage loss where the protective cartilage that cushions the ends of bones wears down over time, leaving a lack of joint space and increased bone on bone pressures. Severe osteoarthritis can lead to total knee replacement surgeries.

Scaling it down from general orthopedics to AFOs specifically, most custom-fit AFOs do not provide coronal plane stability. Instead, they focus on the sagittal plane.

An ankle/foot deformity can range from mild to severe in regards to flexibility and varus or valgus deformity.

Elevate designed a solution for their custom fit AFO’s that address the coronal plane. The HelixBand dynamically influences position of the midfoot and calcaneus to control either varus or valgus instability throughout the entire gait cycle with adjustable levels of support. It’s designed to replicate ligaments and muscular attachments for natural gait biomechanics.

Learn more about HelixBand here.