Flatfoot is a change in the shape of the arches of the foot, accompanied by the loss of its cushioning( spring) functions. Depending on which particular arch of foot is flattened, the transverse and longitudinal flat feet are distinguished. Also distinguish congenital and acquired flat feet. About 45% of all adults suffer from various forms of flatfoot. Pathology is more common in women. Flat feet are the cause of foot pain that occurs during walking. Often when flat feet on the sole are formed calluses and corns, the deformation of Hallux valgus. In addition to radiographic examination, flatfoot diagnostics include planography and sub-metering. Treatment consists in the constant wearing of insteps or orthopedic shoes, periodic passage of massage courses, exercise therapy and physiotherapy.
Flatfoot - change in the shape of the arches of the foot, accompanied by the loss of its damping( spring) functions. About 45% of all adults suffer from various forms of flatfoot. Pathology is more common in women.
The foot restrains the body weight, prevents the person from falling during walking, plays the role of shock absorber and lifting mechanism. In carrying out all these functions, the arches of the foot are of great importance-rigid and at the same time elastic formations, which include the bones of the foot, its ligaments and muscles.
There are two arches of the foot: transverse( an arc from I to V of the metacarpal bone, which becomes visible if the arm is taken by hand from the sides and squeezed in the transverse direction) and longitudinal( arc in the region of the inner edge of the foot).The purpose of the arches of the foot is to keep the balance and protect the body from shaking while walking.
With the weakening of the musculoskeletal structures, the muscles and ligaments of the foot stop coping with the high load, the foot is flattened, "settles".Her cushioning function is reduced. Concussions during walking are transmitted to the higher parts( spine and joints of the lower limbs), in which degenerative changes develop due to constant overload( osteoarthrosis, posture disorders, osteochondrosis).
Classification of Platypodia
When flattening the transverse arch, the feet are referred to as transverse flat feet, while flattening longitudinal - about longitudinal flat feet. In the case when both arches are flattening, a combined flatfoot develops.
Probably acquired and congenital platypodia. Congenital flat feet - a rare pathology( 2-3%), caused by a violation of the development of the foot in the intrauterine period. In children, a congenital flat foot is usually diagnosed at the age of 5-6 years, because at an early age the arches of the foot are not yet sufficiently developed, and the signs of flat feet are normal in all children.
Acquired platypodia can occur at any age. Depending on the causes of development in traumatology and orthopedics, it is divided into:
- Static flat feet. A common form of flatfoot( more than 80%).The cause of the development of pathology is the weakness of the bones, muscles and ligamentous apparatus of the foot and shin. There is a hereditary predisposition to the development of flat feet due to inherited weakness of the ligaments. The risk of flatfoot development increases with increasing body weight, insufficient physical activity in people sitting in occupations, "standing work"( sellers, hairdressers, pickers on conveyors, weavers, etc.), wearing uncomfortable shoes, aging. Static flat feet can develop and due to the constant wearing of shoes with high heels( due to excessive load on the forefoot).
- Traumatic platypodia. It develops after a fracture of the bones of the foot, calcaneus and ankles.
- Ricky flatfoot. Occurs after rickets. The cause of development is a decrease in the strength of bones and a violation of the formation of the skeleton of the foot.
- Paralytic platypodia. Develops after poliomyelitis. The cause of flatfoot is the paralysis of the tibial muscles and the plantar muscles of the foot.
Transverse platypodiaThe proportion of transverse flat feet according to various data is from 55% to 80%.The disease usually develops in middle-aged people( 35-50 years).Women suffer from transverse flatfoot 20 times more often than men.
This type of flatfoot is characterized by a decrease in the length of the foot, a fan-shaped divergence of the bones of the metatarsus, a deformation of the first finger( Hallux valgus), which in everyday life is commonly called a "bone", and hammer-shaped toes of the foot.
Normally, the transverse arch of the foot, formed by the heads of metatarsal bones, has the shape of an arch. The main support during standing and walking lies on the heads of V and I metatarsal bones. With the development of flatfoot weaken support structures of the arch of the foot: plantar aponeurosis, which carries the main burden of retaining the arch, the interosseous fascia and the muscles of the foot.
The support is redistributed to the heads of all metatarsal bones, while the load on the metatarsal head I decreases, and the load on the head II-IV of the metatarsal bone sharply increases. I finger deviates to the outside, the metatarsal I head and I finger form an angle. In I metatarsophalangeal joint, osteoarthritis occurs. There are pains, the volume of movements in the joint decreases.
The increased pressure of the heads of metatarsals causes thinning of the layer of subcutaneous fat on the plantar surface of the foot, causing a further decrease in the damping function of the foot. On the soles in the region of the heads of metatarsal bones are formed.
Depending on the severity of the angle between the first finger and the I metatarsal bone, the following degrees of transverse flatfoot are distinguished:
- I degree. Angle is less than 20 degrees. Slightly flat feet.
- II degree. The angle is from 20 to 35 degrees. Moderate flat feet.
- III degree. The angle is more than 35 degrees. Sharply pronounced flat feet.
Symptoms of transverse platypodia
As a rule, patients with transverse flat feet consult a doctor about a cosmetic foot defect, less often - for pain during walking, trampling on the soles, rough skin growths or inflammation in the I area of the metatarsal joint( Hallux valgus).
However, the survey usually shows that the patient with flat feet for a long time worried more or less pronounced burning or aching pain in the foot while walking. Upon examination, the deformity of the foot is revealed: flattening of its transverse arch, characteristic deformation of the metatarsophalangeal joint, with pronounced flat feet - hammer-shaped toes of the foot.
Treatment of transverse flatfoot
Conservative therapy is effective only at the first stage of flatfoot. The patient is recommended to reduce body weight, choose comfortable shoes without heels, reduce static loads on the foot. It is shown wearing special insoles and rollers.
With flat feet II and III degree, surgical treatment is performed. There are many methods for correcting the deformation of the 1st finger, however, no operation eliminates the cause of transverse flatfoot - the weakness of the ligaments and the muscles of the foot. Perhaps isolated surgical intervention( resection of Hallux valgus - the protruding part of the bone) and surgical treatment, including resection of the bone site in conjunction with the plastic capsule of the joints and the transplantation of the tendons. In the postoperative period, a flat-footed patient is recommended constant wearing of insteps or shoes with special insoles.
Longitudinal flat-footThis form of flatfoot flattenes the longitudinal arch of the foot. The foot lengthens, spreads out and comes in contact with the support almost the entire sole. The proportion of longitudinal flat feet is 20 to 29%.The disease often develops in young patients( 16-25 years).
Bones, muscles and ligaments of the foot and lower leg are involved in the process. The bones of the foot are moved in such a way that the heel bone unfolds to the inside, and the front parts of the foot deviate to the outside. The tension of the tendons of the peroneal muscles increases, and the sinews of the anterior tibial muscle - decreases. The middle part of the foot expands. The patient's walk becomes awkward, when walking, he strongly breeds socks to the sides.
There are four stages of longitudinal flatfoot:
- stage of pre-illness( prodromal stage);
- intermittent flatfoot;
- flat stop;Platellipose foot.
At the stage of pre-sickness of the patient with flat feet, worries about fatigue during walking, pain in the upper part of the arch of the foot and muscles of the shin after prolonged static loads.
In the stage of intermittent flatfoot pains appear not only towards the end of the working day, but after a long standing or long walk. The tension of the calf muscles is revealed, sometimes their temporal contractures develop. The longitudinal arch of the foot has a normal shape in the mornings, but by the evening it becomes flattened. To assess the severity of flat feet use special techniques( dermatology, planography, radiography).
During the development of a flat foot, the pains appear even after small static loads. The foot expands and flattenes, the height of its arch decreases. Gradually, the gait begins to change.
There are three degrees of flat foot:
- I degree. The stage of the beginning of formation. The height of the arch of the foot is less than 35 mm;
- II degree. The height of the vault is 25-17 mm. In the joints of the foot, osteoarthritis begins to develop;
- III degree. The height of the vault is less than 17 mm. The anterior parts of the foot are unfolded and flattened. The deviation of the first finger outward is detected. In this case, the pain in the foot is temporarily reduced.
In the absence of treatment in the future develop ploskovalgusnaya foot, at which pain occurs at the slightest static load. The valgus deformation( a sharp turn of the foot by the plantar side to the inside) is revealed and the flattened arch of the foot is expressed.
Treatment of longitudinal flatfoot
In the stage of pre-illness, the patient is advised to work out the correct gait( without breeding socks), walk barefoot on sand or uneven surface and regularly unload the muscles of the arch of the foot, while standing periodically transferring the load to the external surfaces of the feet. Patients with flat feet are prescribed exercise therapy, massage and physiotherapy: magnetotherapy, CMT, hydromassage, etc.
In the stage of intermittent flat feet, a recommendation is added to the listed activities to change working conditions to reduce the static load on the feet.
With a flat foot to the complex of therapeutic measures, orthopedists are assigned to wear orthopedic shoes and special insoles. With further progression of flat feet, surgical treatment is indicated.
In the stage of flat-footed foot conservative methods are ineffective. Various plastic operations are performed: resection of bone sections, transplantation of tendons, etc.
Treatment of flat feet in adults |Center of Traumatology and Orthopedics
Flattening is a deformation that leads to flattening of the foot and loss of its physiological functions.
With flatfoot, the bone structures of the posterior and middle parts of the foot are gradually installed in such a way that leads to the omission of the arches.
Anatomically the foot has two main arches - transverse( between the bases of the fingers) and longitudinal( along the inner edge), which are designed to absorb the load and maintain the body weight. Depending on the type of arch that falls, three types of flatfoot are distinguished: longitudinal, transverse and combined( longitudinal-transverse flatfoot).In most cases, it is the combination of flat feet that predominates, because if deformation develops, both arches of the foot drop. The consequence of this dysfunction, as a rule, is a flat valgus deformation of the feet.
The development of flat feet occurs due to the fact that the ligament of the foot weakens with time, the calcaneus begins to fall down from the outside and the entire foot moves inwards towards the central point. At the same time, the vaults drop, and it often happens that the bone, which can be palpated on the inner part of the foot, practically touches the surface. There is overgrowth of certain structures of the foot, ligaments, which causes pain when walking. When a person moves and walks a lot, after a while there is fatigue, discomfort and at night the legs begin to get very tired and sick.
Many people do not consider this disease serious, and they do not ask "How to cure flat feet?" But, unfortunately, frivolous attitude towards this pathology can lead to complications: deforming arthrosis of the foot joints, knee and hip joints, osteochondrosis, scoliosis, valgus deformityfeet.
Flat-footedness develops very slowly and gradually, usually from childhood. But if in childhood the diagnosis of flat feet does not cause certain clinical symptoms( pain, discomfort, fatigue) then, unfortunately, after tens of years, it begins to manifest and disturb very much. Often the pains are such that a person can not always pass a sufficiently long distance.
In addition, with the development of flatfoot there is a certain redistribution of the load on the bones of the foot, the biomechanics of motion changes and this causes overstrain in the knee and hip joints, which leads to the pronation of the pelvis and, as a consequence, to the scoliosis of the spine.
Sometimes scoliosis is diagnosed in a child only when it is standing - when it lies down, the spine straightens. This is the so-called functional scoliosis, which manifests itself only under load. And if the child is made insoles, which return the foot to a normal physiological state and raise the arch of the foot, the load on the problem areas is reduced and the scoliosis disappears.
Symptoms of flatfoot
The main symptom of developing flat feet is pain in the feet, ankles and lower leg, especially after prolonged movement. The gait becomes heavy, "unnatural."In addition, flat feet is the cause of cones on the legs( Valgus deformation of the first finger), which leads to deformation of the foot. In connection with the fact that with flatfoot disruption of the natural distribution of the load, pain can also occur in the knee and hip joints, often in the lower back.
Degrees of flatfoot development
1 degree. Poorly expressed deformation of the foot, fatigue and painful sensations arise, as a rule, after a long stay on the legs.
2 degree. Deformation( flattening) is seen during normal inspection. The foot begins to "flatten out", a small blockage of feet appears inward. Painful sensations arise not only in the foot, but go over to the shin and knee.
3 degree. A pronounced deformation. Violations begin in the work of the musculoskeletal system, and pain arises even after a short walk. Often there is a Valgus deformation of the first finger( more about getting rid of cones on the legs), leading to severe deformation of the foot, the appearance of corns, "hammer-like" fingers.
Diagnostics of Platypodia
An orthopedic surgeon performs visual examination of the foot and is scheduled to perform radiography. Based on the X-ray images, the final diagnosis is made - the degree of development of the disease and the type of flatfoot are determined. Depending on this, the specialist chooses a method of treatment( conservative or operative) and develops a therapeutic program.
How to get rid of flat feet?
It is rather difficult to get rid of flat feet with conservative methods of treatment. This is possible only at very early stages of development, if the flat feet are detected at the age when the child is still very small( 3-5 years).If at this moment it will be possible to inspire the child that he needs to engage in certain exercises that need to be done for a long time, then he will not have a flat foot in the future. Also, in addition to exercises, flat feet in children can be adjusted with insoles, orthopedic appliances, special shoes. Unfortunately, most often this does not happen and flat feet, as a rule, develops.
Conservative treatment methods that would have helped to cure flat feet in adults, in fact, do not exist. We can use individual orthopedic insoles, perform various physiotherapy procedures, do massage, physiotherapy, acupuncture, but all this will be directed only at suspending the already existing deformation, so that the flat feet slowed down. But if the flatfoot already exists and, especially if it has reached the started stages, then it can be cured only in an operative way.
Of course, the phrase "flatfoot surgery" causes fear, but to date there are such surgical interventions that allow you to quickly and slightly traumatologically get rid of flat feet through small incisions. The essence of these operations is that, bone structures, with the help of a special implant, set in anatomically correct position. The patient goes for several years, during which the ligaments and muscles get used to this condition, and then the implant is removed.
This small operation has very high efficiency and is carried out at any stage of flatfoot development. For the treatment of flat feet in adults in the advanced stage, in addition to this method, additional corrective techniques can also be used.
Recovery after minimally invasive interventions occurs within a week. If you have to do more serious operations, the recovery can be longer and depends on the amount of surgical intervention performed.
The effectiveness of these operations is so high that, as a rule, if a patient does surgery on only one leg, then in 99% of cases he will come again to do the operation on the other.
Features and types of the disease
The transverse arch of the foot is located between the fingers, and the longitudinal arch is along its inner edge. In connection with this, several types of flatfoot are distinguished:
- combined, when a person has at once two types of flatfoot.
The disease is congenital and acquired, and is found not only in adults, but also in children. Unfortunately, the presence of this problem in children worries parents more than the appearance of flat feet in themselves. Rarely, who from adults considers this deformation as a disease, and in fact flat feet leads to many complications associated with the musculoskeletal system.
There are also 3 degrees of flatfoot, which are distinguished by factors such as the degree of flattening of the foot and the presence of complaints from the patient. The occurrence of this disease in adults is often associated:
- with excess weight;
- weakness of the muscles and ligaments of the foot;
- transferred to childhood rickets;
- as well as with professional activities.
1 - normal stop.2 - "hollow" foot( the longitudinal arch is excessively high).3 - valgusa foot( longitudinal arch is flattened).4 - flattened foot( longitudinal and transverse arch are flattened).5 - flat-valgus foot( longitudinal and transverse arches absent).
When to treat
Before fixing a flatfoot in an adult, the doctor must determine the variety, shape and extent of the disease. In what cases should I treat flatfoot? The opinions of doctors on this occasion are somewhat different. Some believe that it is necessary to treat the disease, while others express the opinion that without any complaints from the patient, it is not possible to conduct any medical measures. Which of them is right? This question can be understood if you approach it logically.
Judge for yourself, because the development of flat feet leads to a change in the biomechanics of the movement of the foot, which in turn causes a redistribution of the load in the legs and an increase in the tension of the musculoskeletal apparatus. Overexertion in the joints of the legs can cause such complications as valgus deformity( ossicles on the feet), arthrosis of the knee and hip joints, scoliosis of the spine and osteochondrosis.
Orthopedics use both conservative and surgical treatment of flatfoot.
- Conservative methods, as a rule, contain a whole complex of measures and are used in the initial stages of the disease.
- Adult operation is used in cases when the disease is started, and the patient is practically unable to move.
Wearing orthopedic insoles with a flat foot is necessary and effective.
The goal of conservative therapy in adults is to strengthen the ligaments and muscles of the foot, shin, back, and also stop the deformation processes in the foot. These measures are particularly relevant in the initial stages of the disease with transverse flatfoot. In this case, the bones of the foot diverge, and the displacement of the inner part of the thumb to the outside causes the appearance of a painful bump( bone) on the foot. If you do not begin treatment with such a deformity in the initial stage of the disease, conservative treatment of transverse flatfoot in adults is ineffective, and only surgery can help.
- Waiver of uncomfortable or tight shoes, as well as shoes with high heels. A small heel will help redistribute the load in the legs.
- Limitation of large physical exertion, ensuring rest( at the time of treatment) and applying a cold compress to the foot. Peace and cold compress relieve swelling and pain.
- Modeling the desired arch of the foot with insoles from flat feet or orthopedic footwear. Insoles-arch supports, which are inserted closer to the front of the foot, have a good curative effect with longitudinal flat feet. To reduce the load on the heel, special backs are inserted in the shoes, and with the deviation of the thumb, you can wear interdigital inserts.
- Taking medications that relieve pain and inflammation. These include non-steroidal anti-inflammatory drugs( diclofenac, ibuprofen) and corticosteroids, which for severe pains are injected into the joint.
- Application of massage, gymnastics and exercise therapy with flatfoot.
Surgery in adults is performed in severe situations, when only surgery can help relieve pain and return the foot to its original position. In these cases, the following types of operations are used.
- Osteotomy - in which the method of dissection of ligaments corrects deformity.
- Excision of deformed bone or bone spur.
- Synovectomy - at which the articular membrane is removed.
- An arthrodesis is an operation whose purpose is to fix bones to the ligaments and muscles. After the operation, it is shown to wear special insoles - orthoses, that help fix the foot in the desired position.
- Transposition of the tendon( plastic deformed tendon in a healthy area of the tendons).
When it is better to apply LFK
Physiotherapeutic methods of treatment, which well strengthen ligaments and muscles, contribute to the preservation of mobility in the legs and other joints of the body.
- Physiotherapy with flat feet, used in the initial stages of the disease, can prevent the occurrence of complications and has a good therapeutic effect with longitudinal flat feet. For this it is enough to perform various exercises for 10-15 minutes 3-4 times a day.
- Exercises for flat feet in adults are aimed at flexing and extending the feet, gripping the toes of small objects, rolling the foot from the toe to the heel and rolling the feet on the rolling pin( any oval object is suitable).Patients with flat feet are useful to walk on grass or warm earth, as well as change the load on individual parts of the foot. For this it is necessary to walk for 2-3 minutes first on the toes, then on the heels or the outer edge of the feet.
- For a flat foot massage, you do not need to go to a massage therapist, just buy a few massage mats and place them in those parts of the house where the person is most often. Foot massage improves microcirculation and strengthens ligaments and muscles. Physiotherapeutic methods of treatment have their effect not only in the early stages of the disease, but also after the operation.
In conclusion, I want to recall that flat feet is a serious disease, which in advanced cases can lead to complications. But this diagnosis is not yet a sentence, and flatfoot prevention is the best medicine.
How much will a flatfoot repair operation cost? Actually what will be the approximate price of such an operation?
There are 2 main methods of treating flatfoot: surgically and conservatively.
Conservative treatment of flat feet includes foot massage, foot baths, electrophoresis, curative gymnastics, wearing orthopedic shoes, special insoles, etc., and is prescribed in the first and second stages of flatfoot development. In some cases, conservative methods of treatment are ineffective, and therefore require surgical treatment.
Also surgical treatment is required for the treatment of the third stage of flatfoot. There are several types of operations with flat feet, but the main goal of surgical treatment is shortening of ligaments, correction of the arches of the foot and elimination of the effects of flat feet( for example, deviation of the first toe of the foot).
You should consult a doctor because the operation is done at the third degree of flatfoot.
Maybe you and the operation is not required, but the doctor knows how much the operation costs and whether it is shown to you or can conservative treatment offer.
Do you have a flatfoot with the destruction of bones already??the question
is not clear
barrage-2,500 euros.and there are no problems. Hurry up the number of applicants is limited.
The people who did the operation on flat feet and is it worth doing it?