Transverse flatfootFlatfoot - a change in the shape of the foot, characterized by flattening, reducing the relief of its plantar surface. This negatively affects not only the foot, but also the entire musculoskeletal system. A heavy degree of flatfoot is the basis for refusing to conscript young men. Few people know that this ailment has varieties. There are flatfoot transverse, longitudinal and transverse-longitudinal.
A bit of anatomy
The main parts of the foot: tarsus, plyusna and fingers. All the bones of these sections are interconnected by a multitude of joints( their number in the foot is 24).In addition, the foot is additionally strengthened by numerous muscles, ligaments, connective tissue tendon plates( fasciae, aponeuroses).All these elements ensure the strength and elasticity of our foot, because it accounts for a significant part of the load when moving and maintaining the body in a vertical position.
Nature has taken care to minimize this load as much as possible. The plantar part of the foot is uneven - due to this it springs when moving, and the load does not apply to the whole surface, but to certain places. The unevenness of the sole has the appearance of bends on its surface, called vaults. In the foot, there are 3 vaults - one transverse and two longitudinal( internal and external).The transverse arch is formed by bones of the tarsus( cuboidal and 3 sphenoidal), and also by the heads of 5 metatarsal bones. What is the transverse flatfoot? This decrease in the height of the transverse arch of the foot, leading to changes in its overall configuration.
The main causes of
Depending on the reasons, this kind of flatfoot can be congenital and acquired. Congenital flat feet mainly develop due to genetically caused disorders of the skeletal structure of the foot or the inconsistency of fixative ligaments and aponeuroses. It should be noted that the foot is finally formed by the age of 6, and many diseases and injuries of the musculoskeletal system in children are potentially dangerous in terms of flatfoot development.
However, the acquired flattening of the transverse arch is most often observed in adults in the age range from 35 to 50 years. The main reasons leading to this:
- excessive load on the foot - constant long walking, wearing weights;
- sedentary lifestyle;
- osteoporosis - decrease in density and structure of bone tissue;
- inflammatory diseases affecting the musculoskeletal system( rheumatism, rheumatoid arthritis, gout);
- trauma of the foot( fractures of bones, ruptures of fascia, tendons, muscles);
- age-related degenerative changes in the musculoskeletal apparatus;
- paralyzes of the lower limbs with defeat of the brain or spinal cord( strokes, craniocerebral spinal cord injuries);
And the most common reason is incorrectly selected shoes - flat sole or too high heel. In the first case, with a load on the foot, her bones diverge, all the arches of the foot fall. Apparently, this is connected with the fact that in many cases there is a transversely longitudinal flatfoot, when a decrease in the transverse arch of the foot is preceded by a decrease in the longitudinal arches. At too high a heel( more than 4 cm) the pressure on the anterior parts of the metatarsal bones grows, which diverges to the sides. With the excessive height of the heel, the fact is connected with the fact that among the people suffering from transverse flatfoot 75-80% are women.
Clinical signs of
The main symptoms of transverse flatfoot are:
- pain in the legs and in the foot, increasing with walking;
- increased overall fatigue;
- edema of the feet;
- appearance of characteristic scuffs and corns at the base of the fingers;
- difficulties in the performance of certain movements( for example, to stand on your toes).
Decreasing the height of the transverse arch leads to the fact that the length of the foot in the longitudinal( anteroposterior) direction decreases, and in the transverse direction, it increases. This changes the distribution of gravity to the foot. Normally, most of the load goes to 1 metatarsal bone. With transverse flatfoot, almost all of the load falls on the middle sections( 2 and 3 metatarsal bones).
In this case, the height of the metatarsal bone over the remaining bones increases, 2 and 3 fingers are deformed( beak-like, hammer-shaped deformation), and the 1st finger deviates outwards. The deviation can be so pronounced that the first finger can be placed over the second one. In this case, at the base of the first finger, the cartilaginous tissue grows excessively in the form of a characteristic cone. It is from the angle of the deviation of the first finger that one can judge the degree of transverse flatfoot. Normally, it is 150. Depending on the severity of the deviation, there are 3 degrees of disease:
- 1 degree - no more than 200;
- 2nd degree - 20-400;
- 3 degree - over 400.
The change in the shape of the foot leads to an increase in the load on the other parts of the musculoskeletal system - the lumbosacral spine, shin, knee and ankle joint. In the future this can cause the development of osteochondrosis of the spine, articular arthrosis.
disease Treatment of transverse flatfoot can be conservative and operative. It should be borne in mind that it is impossible to completely get rid of transverse flatfoot, and all medical measures are aimed at eliminating symptoms and preventing flatfoot progression. Conservative treatment is effective with flat feet of 1-2 degrees and includes:
- therapeutic exercise;
- folk remedies;
- orthopedic appliances.
Exercises for feet involve walking on toes and on the heels, on the outer and inner sides of the foot, rolling from the heel to the toe and back, lifting the light objects( pencil, handle) with your toes. It is also recommended, while sitting, to flex and unbend fingers. All these exercises are designed to strengthen the musculoskeletal apparatus of the shins and feet. This is also facilitated by the massaging of the shins and feet, held in the self-massage. All this is quite feasible at home, but on the recommendation of a massage therapist and specialist LFK.
Among the folk remedies used for transverse flat feet are floral and herbal infusions, decoctions( linden, sage, plantain, yarrow), as well as various mixtures of honey, onions, garlic, sea salt, iodine. All this is used in the form of foot basins, compresses, lotions, which strengthen muscle tone, reduce pain, prevent the development of inflammation.
With flatfoot it is necessary to use special orthopedic insoles. Such insoles are made of polymer materials, repeat the contours of the foot and have thickenings in the problem areas - at the base of the fingers. They use it constantly. To wear shoes must be strictly in size, not tight and not narrow. The optimal height of the heel is 3-4 cm. And it is best to use a special orthopedic footwear, equipped with insoles insole and made to order.
With transverse flatfoot of grade 3 with severe pain, surgery is prescribed. In the course of surgery, correction and fixation of transverse water bones, plastic of ligaments, removal of excess cartilaginous tissue are carried out.
Symptoms and treatment of transverse flatfoot
The human foot consists of many small bones, joints, ligaments and tendons connected together.
Incorrect wearing of shoes, overweight, various injuries and many other causes can disrupt the fragile balance of the system that the foot represents. Because of , abnormalities in the ligament, joint or bone arrangement, the anatomical arches of the foot begin to flatten.
Over time, flattening can progress, and may remain at a certain stage continuously. And in that, and in that case it gives an occasion to diagnose a flat foot.
The classifies several species of the disease:
- Transverse platypodia , in which the foot "spreads" in width, develops bone-cartilaginous growth. Instead of giving a load to the arch support, the foot is flattened and expands an additional support in the form of a joint, popularly known as a "bone".The risk group for this type of disease is women and men aged 35 to 55, especially those who are overweight.
- Longitudinal flat feet, , on the contrary, manifests itself in the extension of the foot in length and is most often observed at a young age - 16-25 years.
- With combined flatfoot , both types of deformities are observed simultaneously, but all of them lead to a flattening of the arch of the foot. The combined variant of the disease is observed most often.
Usually a predisposition to flat feet is inherited, but there are also types of acquired flat feet, to which there was no inclination.
- Static - formed due to standing work, hypodynamia, excess weight, increased loads on the foot, endocrine diseases.
- Paralytic - arose after the paralysis of limbs and the dysfunction of the muscles that hold the arch of the foot.
- Traumatic - physical changes due to trauma.
- Ricky - acquired, developed due to a lack of vitamin D.
According to the degree of development, weak, initial, and progressing flat feet.
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Why is the foot flattening?
There are several reasons for transverse flatfoot.
- Genetic predisposition. As already mentioned, most often flat feet manifests as a congenital disease. It arises from the inherent weakness of the muscles of the arched arch, which is also called the "aristocratic foot".If a person leads a healthy lifestyle, eats properly, receives moderate physical activity, wears good shoes, then this type of flatfoot does not progress and practically does not cause trouble.
- Disturbances in the muscular and ligamentous apparatus of the foot. In a healthy person, the phalanges of the toes should run parallel to each other. But, as a rule, the slightest and inconspicuous disruption in the development of muscles or ligaments leads to the formation of a fan-shaped arrangement of phalanges. Over time, the phalanges "creep" in the sides, and because of this, a transverse flatfoot arises.
- Overweight. The arch of the foot, as well as its muscular and ligamentous apparatus in general, is designed to work only with a certain weight. If it goes beyond the norm, the load on the foot increases, it flattenes.
- The same situation is observed in people with normal weight, but having an excess load on the foot due to the type of activity. So, the work of a lecturer, teacher, factory worker and many other professions are considered "standing", that is, a man spends most of his days on his feet. Excessive loads disrupt the balance of the foot, the acquired flat feet develop, which is considered an occupational disease.
- Traumas of the foot are one of the most common factors in the development of flat feet in men. Fractures of the foot bones, dislocations, stretching of the muscles and ligaments, violation of the integrity of the calcaneus bone lead to disruption of the foot apparatus and progressive flat feet.
- Walking on heels, wearing uncomfortable shoes with an unsuitable shoe and other violations of foot hygiene - almost one of the most common causes of the development of acquired flat feet. When walking on heels, for example, the entire weight of the body is transferred to the front of the foot. Instead of spreading evenly over the entire support, it presses and eventually deforms bones that are not ready for such loads. It is because of the heels, and also because of the transfer of the hereditary predisposition to flat feet along the female line, that the ratio of women and men suffering from this disease is eight to two, respectively.
Symptoms that indicate the development of the pathology
The development of flatfoot is easy to recognize. The most common symptoms that accompany transverse flat feet:
- Constant pain and the emergence of a strong sense of fatigue in the feet, which is especially pronounced by the end of the day.
- Burning and cramps in the shin area of , usually not associated with uncomfortable position, hypothermia and other external factors.
- Deformation of the foot and change in the location of the phalanges of the fingers.
- The appearance of a kind of cone at the base of the thumb( usually called a "bone").
- With progressive flat feet - violation of posture, pain in knees and pelvic joints, discomfort in back.
- With the development of the disease, deforms the entire front part of the foot .
How to diagnose a diseaseYou can diagnose platypodia when examined by an orthopedic physician or traumatologist, which will reveal the type of disorder and the degree of flatfoot progression.
Based on the results of the examination, the doctor can prescribe various methods of treatment.
In the picture, a foot check for longitudinal and transverse flatfoot
disease Treatment of transverse flatfoot in adults should be complex.
Conservative methods of include:
- Reduces the load on the foot, up to its immobilization in especially severe cases.
- Wearing individually selected orthopedic shoes .In difficult cases, this can be a special footwear, fixing not only the foot, but also the shin. Orthopedic insoles and helium inserts are used at the initial stage of flatfoot. All of them should be appointed by a doctor and selected individually.
- Weight loss measures for , if it was determined to be excessive.
- Common restorative exercises for the treatment of transverse flat feet, part of the curative physical training course.
- Medications( analgesics) are prescribed with progressive flat feet and the presence of arthrosis or bursitis.
- Physiotherapy and massage , aimed at relieving pain, relaxing the muscles of the foot.
- To relieve tension, prevent cramps, reduce pain, also uses refreshing foot baths, cool compresses, ointments based on mint and menthol.
Nonconservative, folk treatment of of transverse flatfoot is mainly aimed at alleviating the pain that occurs during the load of feet during flatfoot.
These include ice compresses, foot baths based on mint, lemon balm, thyme, marigold, chamomile, linden and lavender.Folk remedies in the treatment of transverse flatfoot can not be an independent method of treating the disease. And they are used only for the relief of pain syndrome.
If conservative methods of treatment do not show a result, irreversible changes occur in the foot, the patient suffers severe pain, surgical intervention is prescribed. As a result of surgery, deformities of the forefoot are treated surgically. A number of modern techniques allow to do this without the subsequent application of gypsum - thus, the rehabilitation period is reduced.
Operative treatment of transverse flatfoot has a significant drawback - the need for complete cessation of loads on the foot during preparation and rehabilitation, but at the same time the issue is solved crucially - the flat foot does not progress and no longer causes regular concern, as in the case of conservative treatment.
To never have problems with the flatfoot , you should pay attention to the convenience of shoes, do not wear high heels, maintain your weight in the norm. People of "standing" professions need to rest more often, change their positions during the performance of duties.
Like most other diseases, flatfoot is easier to prevent than cure.
Video: Transverse platypodia and bones on the legs
Transverse platypodia is a widespread pathology in which there is a transverse spreading of the foot and a deviation of the 1st finger outward. The main cause of transverse flatfoot is the failure of the ligamentous apparatus of the foot. Along with the external deformation, it is manifested by pain in the feet, pain and burning in the muscles of the feet and lower legs after physical exertion. The diagnosis is made on the basis of radiography. Symptomatic conservative therapy is performed, with severe deformation, corrective operations are performed.
Transverse platypodia - a pathological condition in which the fore parts of the foot are flattened, and I finger deviates to the outside. Pathology is widespread, women suffer about 20 times more often than men. It is usually found in middle-aged and elderly women, less common in men( usually elderly people), in some cases found in children and adolescents. In traumatology and orthopedics, there is often a combination of transverse and longitudinal flat feet - combined flat feet.
Usually accompanied by a more or less pronounced pain syndrome, severity in the feet and rapid fatigue when walking. Over time, there is stiffness of metatarsophalangeal joints, progressive deformations in the region of the first and second fingers. The reason for going to the doctor, along with the pains, often becomes a pronounced cosmetic defect and problems in the selection of comfortable shoes. Treatment of transverse flat feet is performed by traumatologists and orthopedists.
Causes and mechanism of transverse flatfoot development
Transverse platypodia is a polyetiological disease that occurs under the influence of various factors, including uncomfortable narrow shoes, high heels, long stay on legs, excess weight, previous trauma to the foot, etc. However, the main reasonthe formation of transverse flatfoot is the inherent weakness of the ligamentous apparatus of the feet. At present, this pathology is considered as an irreversible deformation, which can not be corrected by conservative methods, since there are no medications or orthopedic adaptations that can affect the restoration of tonus and strength of connective tissue formation of the foot.
Normally metatarsal bones are held in anatomically correct position due to the interosseous fascia and plantar aponeurosis. With the weakness of these connective tissue structures in 30% of cases, all the bones of the metatarsal are diverging in a fan-like manner. In 27% of cases, I deviate from the metatarsal bone in the medial aspect, and the remaining metatarsal bones retain their normal position. In 5-6% of cases the diameter of the foot increases due to the deviation of V and IV metatarsal bones. In other cases, combinations of these options are observed.
The deviation of metatarsal bones is not the only pathological change that occurs with transverse flatfoot. I metatarsal bone often turns around its axis and rises. There is a redistribution of the load: I metatarsophalangeal joint becomes inferior, and the external parts of the foot are constantly suffering from overload. Due to the change in normal relationships between the elements of the foot and the traction of the muscles, the toe of the foot "leaves" outside. I metatarsophalangeal joint is deformed.
A "bone" is formed on the inner surface of the foot, which can represent both an exostosis( bone-cartilaginous growth), and a combination of exostosis with an outstretched curved I metatarsophalangeal joint. Because of the excessive pressure of the shoe on the metatarsal bone in the joint area, bursitis occurs, accompanied by local edema and reddening of the skin. Arthrosis of the metatarsophalangeal joint arises, which causes an increase in the pain syndrome. The amount of movement in the joint is reduced.
Curved I finger "goes" on the 2nd finger. Over time, hammer-shaped deformation II is often formed, more rarely - II-III fingers, on the plantar surface are formed napotypes. Plyusnefalangovye joints "go" into a state of subluxation. All of the above causes intense pain, creates severe discomfort when wearing ordinary, and sometimes - orthopedic shoes, leads to a forced limitation of mobility and ability to work.
Symptoms of transverse flatfoot
Patients with transverse flatfoot complain of aching, pulling, stitching or burning pain in the feet, mainly in the area of I-II metatarsophalangeal joints. The pains intensify after a prolonged stay on the legs, can be accompanied by a feeling of heaviness in the feet and a burning sensation in the muscles. By the evening, there may be swelling of the feet and the area of the ankles. Patients report severe difficulties in walking on high heels, as well as problems in choosing shoes - the foot becomes too wide and does not fit into standard shoes.
Visually defined valgus deformation of the 1st finger( Hallux valgus).The forefoot is dilated. In advanced cases, a hammer-shaped curvature of the II-III fingers is revealed. The skin in the region of the I metatarsophalangeal joint is thickened, hyperemic. On the internal and plantar surface in the forefoot of the foot are visible on the ground and calloused. The volume of movements in metatarsophalangeal joints is limited. With palpation, pain is possible.
Diagnosis of transverse flatfoot
The diagnosis of transverse flatfoot is made based on external examination data and the results of the radiograph of the foot. To obtain a complete picture of the disease, usually X-rays of I, II and III plus-nefalangeal joints are prescribed. In the process of describing the images, the radiologist assesses the severity of the valgus deformation of the 1st finger, taking into account the angle between the first finger and the metatarsal II and the angle between the I and II metatarsal bones. There are three degrees of deformation:
- 1 degree - the angle between the 1st finger and the II metatarsal does not exceed 25 degrees, the angle between the I and II metatarsal bones does not exceed 12 degrees.
- 2 degree - the angle between the 1st finger and the II metatarsal bone does not exceed 35 degrees, the angle between the I and II metatarsal bones does not exceed 18 degrees.
- 3 degree - the angle between the 1st finger and the II metatarsal bone exceeds 35 degrees, the angle between the I and II metatarsal bones exceeds 18 degrees.
In addition, when studying the radiographs pay attention to the presence of arthrosis, which is evidenced by deformation of the articulation site, narrowing of the joint gap, osteosclerosis of the subchondral zone and marginal proliferation. If necessary, for a detailed study of dense structures, the patient's feet are directed to CT scans, to assess the state of soft tissue - on MRI.In the presence of concomitant pathology from the nervous or venous system, appoint a phlebologist and neurologist.
Treatment of transverse flatfoot
Tactics of treatment are determined depending on the severity of the pathology, the intensity of the pain syndrome and cosmetic needs of the patient. It is worth noting that modern medicine does not know the non-surgical ways of eliminating the deformity of the I metatarsophalangeal joint, and all the proposals to "remove the stone without surgery" are just advertising stunts. Conservative therapy of transverse flatfoot is aimed at reducing pain and slowing the progression of the disease.
In the early stages, patients are advised to wear interdigital ridges and individual orthopedic insoles. In severe strains, orthopedic footwear is manufactured according to individual measures in accordance with the recommendations of an orthopedic physician. In addition, massage, foot baths, a special set of exercises for strengthening the muscles and ligaments of the foot, as well as physiotherapeutic procedures: magnetotherapy, UHF, electrophoresis with trimecaine or novocaine, phonophoresis with hydrocortisone, inductothermy, paraffin and ozocerite. For pain and signs of inflammation, recommend NSAIDs of local and general action.
Operations are performed with severe deformities of the foot and severe pain syndrome. The cause for surgical intervention in young women is often a cosmetic defect with moderately pronounced valgus deformation of the 1st finger. Depending on the features of the pathology, surgical interventions on soft tissues, on the bones, as well as combined interventions on soft tissues and bones are used. Treatment is carried out after the necessary examination, in a planned manner, in conditions of orthopedic or traumatology department.
When performing operations on soft tissues, the tendons are cut off or moved to restore the uniformity of the traction of the muscles that divert and lead the finger. Among the palliative interventions that eliminate external deformities but do not affect the vicious position of the metatarsal I include the excision of the subcutaneous sac and exostosis in the region of the I metatarsophalangeal joint. Such operations can reduce the cosmetic defect and facilitate the use of standard footwear, but over time their effect often disappears due to further progression of deformation.
In order to eliminate the deviation of I metatarsal bone to the inside, Scarf osteotomy or chevron osteotomy is currently the usual procedure, during which the orthopedist removes a bone fragment and restores its anatomically correct position. After surgery for 6 weeks, use special orthoses. In the future, the patient is recommended not to overload the foot, wear comfortable wide shoes, do self-massage and perform special exercises to strengthen the muscles of the foot.
Cross platypodia: symptoms, treatment, photo, preventionFlattening is a predominantly acquired disease of the musculoskeletal system, accompanied by a violation of walking mechanics, a change in the shape of the foot, which normally distinguishes between the transverse and longitudinal arches. Flattening promotes pathological changes occurring in the spine, knee and hip joints and other organs. Among several species, a transverse flatfoot is distinguished, accompanied by a flattening of the transverse arch of the foot, the characteristic feature of which is the formation of the so-called "bump" in the region of the big toe. The disease occurs mainly in women in the age range from 30 to 50 years. The appearance of flat feet directly depends on the excess excess weight, under the influence of which the foot becomes a little shorter and thicker.
Reasons forAn important structural element of the foot is its arch. Thanks to it, the foot distributes the load of the body during the movement. The lead contributes to depreciation, balances, etc. The main cause of transverse flatfoot is the disruption of the functioning of the ligament apparatus of the lower limbs, which is transmitted by inheritance. The predisposing factors of flatfoot are:
- 1) Extra kilograms of weight that increase the load on the ligament apparatus of the legs and especially the foot;
- 2) Paresis or paralysis of the muscles of the lower limbs;
- 3) Prolonged wearing of unsuitable close-fitting shoes with high heels;
- 4) Flat feet are often the result of professional activity( seller, hairdresser, etc.), when it takes a long time to stand in a standing position.
Symptoms of transverse flatfootIn many cases, transverse flatfoot begins with subtle symptoms. At first, there are no visible changes in the foot area. By the end of the working day, a slight discomfort in the leg area worries. After a while, the symptomatology increases, including a change in the shape of the feet. For each degree of transverse flatfoot, the following symptoms are typical:
- 1) At the first degree of flatfoot there is fatigue of the feet, pain in the area of the fingers. The skin on them becomes thicker. The angle of deviation of the thumb is 20 degrees( at a rate not exceeding 10 degrees);
- 2) With the second degree of flatfoot, the angle of deviation of the thumb reaches no more than 40 degrees. Physical exercise increases the feeling of pain and burning, which are noted not only in the fingers, but in the entire foot. Characteristics of the choice of shoes;
- 3) At the third stage of flatfoot symptoms of the disease are pronounced. The angle of deviation of the thumb is more than 40 degrees, which is outwardly manifested by the formation of a "cone".The shape of the foot changes noticeably. It becomes shorter and wider. Pain is noted even in rest. Corns and corns are formed. Against the background of flat feet develop joints of the legs and spine.
Diagnosis of the diseaseThe orthopedist is engaged in the diagnosis and treatment of transverse flatfoot. At the initial visit, an examination is carried out, complaints of the patient are taken into account. Additional methods of research, specifying the degree of flatfoot, include:
- 1) Plantography - a method that allows you to obtain a footprint on paper. A similar method of determining flat feet can be carried out at home. For this, it is necessary to lubricate the sole with any coloring material and stand on the sheet of paper, assuming the usual position of the body. From the obtained fingerprint it is indirectly possible to judge the presence and stage of flatfoot;
- 2) X-ray examination is one of the reliable methods, allowing to assess the nature of the changes, the degree of the disease, to follow the dynamics of the pathological process. The X-ray is done in two projections in the patient's standing position;
- 3) The method of electromyography determines the condition of the calf and foot muscles due to the registration of the impulses sent from the surface by a special device;
- 4) Modern diagnostic methods include computer-hardware complexes that allow to determine with the greatest accuracy the shape, width, length, foot index, etc.
Treatment of transverse flatfootConservative treatment methods include:
- 1) Use in wearing special shoes and orthopedic insoles;
- 2) Performing special physical exercises that strengthen the ligamentous apparatus of the foot;
- 3) Therapeutic massage will improve blood circulation, eliminate swelling in the area of the feet;
- 4) Physiotherapy procedures, for example, phonophoresis with hydrocortisone, electrophoresis with novocaine - will temporarily reduce the senses of pain.
- 5) The medications related to the NSAID group( diclofenac, indomethacin, voltaren, etc.) help to relieve pain. They are used in the form of tablets, ointments, creams.
Changes in the shape of the foot, which can be flattened and reduced the surface of the soles, are called flat feet.
that ailment has negative consequences not only for the foot, but for the whole musculoskeletal system as a whole. The severe degree of flat feet is even a medical contraindication to military service.
that the disease has varieties. Doctors distinguish such forms of flatfoot:
The lateral flatfoot appears due to the flattening of the transverse arch of the foot. The disease is not often independent, usually this variety of flat feet develops against the background of the already existing longitudinal flattening that appeared in childhood.
In the medical literature, transverse flatfoot often occurs under the name of a transversely spreading foot with a deviation to the outside of 1 finger.
Predisposing factors for the onset of the disease are:
- professional activity associated with prolonged standing,
- excess weight,
- decrease in muscle elasticity and strength with prolonged sedentary lifestyle or aging.
In the emergence of the disease an important role is played by the condition of a special tendon, plantar aponeurosis, with its insufficiency associated with the direct occurrence of the disease.
Transverse flattening of the foot can be both congenital and acquired.
The cause of congenital flat feet is genetically caused disorders in the structure of the skeleton of the foot or the pathology of the tendons and fixing ligaments.
The most common congenital weakness of the arched arch muscles, this disease is also known as the "aristocratic foot".
To exclude the progression of the disease and related health problems, one can lead a healthy lifestyle. It is necessary to eat rationally, give orgagna sufficient, but not excessive, physical activity and choose high-quality footwear.
Congenital pathologies in the ligamentous and muscular apparatus of the foot lead to the fact that the phalanges of the fingers acquire a fan arrangement, although normally should be located in parallel. With age, they "creep" in the sides, resulting in the development of a transverse flatfoot.
In addition, the final formation of the foot is completed only to six years, so any childhood injuries and diseases of the musculoskeletal system are potentially dangerous from the point of view of flatfoot development.
The roots of the acquired transverse flatfoot should be sought in the patient's lifestyle. The main reasons are:Excess weight. Bone, muscular and ligamentous arches of the arch of the foot are designed for functioning only with normal weight. In the event that the mass of the body exceeds the limits of the norm, the load placed on the foot increases, resulting in a flattening.
If the footwear is non-physiological, instead of harmoniously distributing the load along the entire support, the weight of the whole body is transferred to the front of the foot. Constant pressure on the bone with time causes them to deform.
- Doctors say that shoes with heels and ancestral transmission on the female line of predisposition to the disease have caused that for two men suffering from this ailment there are 8 women.
Indirectly provoke transverse platypodia can:
- paralysis of the legs;
- muscular weakness of the lower limbs;
- hereditary factors;
Symptoms of transverse flattening of the feet are most often:
- burning sensation in the foot,
- feeling of extreme fatigue in the legs by the end of the day.
If the disease progresses and reaches grade 3, intense pain can occur in the knee and hip joints, even if the movement is not associated with resting on the aching leg.
Symptomatic increases with the flattening of the transverse arch and the expansion of the forefoot.
Against this background, with flatfoot progression to the 2 nd and 3 rd degree, the valgus deviation of the thumb arises. It is easy to diagnose visually - a kind of cone grows in the region of the metatarsophalangeal articulation of the thumb.
In this case, the test load is redistributed between the remaining fingers. The load becomes excessive, the biomechanics of the foot work undergoes enormous changes, as a result of which the fingers become hammer-shaped.
Especially negatively the disease affects in childhood, because the calcium content in the bones of children is small, they consist mainly of cartilaginous tissue. And in the case of excessively strong pressure on the front of the legs and fingers, the deformation process of the bones starts very quickly.
In this case, children do not have varus or valgus deformities of one finger, the remaining symptoms are similar to those of flat feet in adults. .
A characteristic clinical picture of flattening of the transverse arch:
- swelling in the ankles;
- increased fatigue of the legs by evening;
- when walking a pronounced pain syndrome;
- discomfort when wearing narrow shoes;
- difficulty walking.
- increased the length and width of the foot.
The orthopedic trauma specialist is engaged in the diagnosis and treatment of flatfoot. Diagnosis is carried out using a number of conservative and instrumental methods.
The doctor collects an anamnesis, performs gait analysis and visual examination of the feet( from the second stage of the disease, its presence can be determined visually) and appoints additional studies.
In particular, in the diagnosis of flatfoot use data:
- Plantography. This method is used to obtain imprints of the plantar surface.
- Podometriya( Friedland method).With its help, the percentage of the height of the foot to its length is determined.
- Radiography. With its help, the degree of transverse flat foot is determined. In the analysis, the angle of the lateral deviation of the first finger is taken into account. In order to determine the degrees of flatfoot, the results of the X-ray patterns of both feet, made with a load in the straight and lateral projections, are necessary.
It is the radiography data that is fundamental in establishing the final diagnosis.
The disease develops on increasing. Doctors distinguish three degrees of transverse flatfoot development.
- For the first degree, the deviation of the angle of the thumb is 20 or more degrees. Thus there are such signs:
- reddening and thickening of a skin of 2nd 4th fingers,
- fatigue of legs after a long standing and walking,
- a pain in the big finger.
- The second degree is characteristic of the transverse flatfoot of medium severity, characterized by the deviation of the first finger by 20-40 degrees. Symptoms are as follows:
- with loads on the leg there is severe pain and burning sensation, covering the entire foot as a whole, not just the fingers,
- skin rending,
- appearance of the burrs.
- The third, last, degree is clearly expressed transverse flattening, the thumb is rejected by more than 35-40 degrees. Symptoms are specific, pronounced:
- intolerable pain at slightest load,
- pronounced flattening of forefoot,
- enlargement of the size of corns,
- thumb modification,
The clinical picture may be accompanied by bursitis and modification of the shape of the legs.
The doctor can appoint an effective treatment only after the establishment of all aspects of the disease - the stage, the cause, the general condition of the patient.
At the initial stage conservative methods of treatment can be used, in neglected cases surgery is necessary. In most cases, conservative treatment is used, including methods and manipulations aimed at reducing pain syndrome and stopping the progression of pathology.
Conservative treatment is mainly based on:
- Lowering the load on the foot y, in even more severe cases, even immobilization is possible.
- Individual selection of physician orthopedic shoes. At the first signs of the disease the doctor can prescribe helium inserts and special orthopedic insoles. In severe cases, a special footwear is selected, which correctly fixes not only the foot itself, but also the shin. Special devices can be chosen that normalize the biomechanics of the feet.
- Activities designed to reduce weight, if it exceeds the limits of the norm. In the presence of obesity, weight loss is one of the most effective drugs in the fight against flatfoot.
- Selection of optimal restorative exercises , effective in the treatment of transverse flatfoot.
- The appointment of medications that stop pain and, if necessary, anti-inflammatory therapy.
- Selection of optimal physiotherapy techniques and massage .These activities help to relieve pain and relax the muscles of the foot. Also, in order to relieve tension in the feet, cool compresses, special ointments and foot baths, which include mint, menthol, medicinal camomile, lavender, linden, thyme, lemon balm and other herbs, are used to prevent seizures and reduce pain.
Patients need to understand that ointments and compresses can not be considered an independent treatment, they only temporarily reduce the pain syndrome! Platypodia is treated only by a doctor with a set of individually selected measures.
In cases when the disease develops against the backdrop of an inflammatory process, analgesics and anti-inflammatory drugs are prescribed.
The need for surgical intervention in the treatment of transverse flat feet is identified by a physician. Deformities of the forefoot are treated exclusively surgically.
Usually, the operation is performed if the flat foot is accompanied by an intense pain syndrome, and conservative methods do not give a result.
The main advantage of surgical treatment is its effectiveness - the disease will not exactly progress.
The main disadvantage of surgical treatment is the need to stop absolutely any burden on the foot during the preparation for surgery and rehabilitation.
At the same time, modern methods allow not minimizing the effectiveness of the operation, as much as possible reducing the time it takes to prepare and rehabilitate the
. It is possible to prevent the occurrence of transverse flatfoot in most cases and is not difficult. The main measures of prevention of transverse flatfoot are:
- high-quality physiological footwear without high heels
- maintaining a normal weight
- adherence to a healthy work and rest regime,
- frequent change of body positions for occupations associated with prolonged standing.
Causes of the disease
Normally, the foot has two arches - longitudinal( along the foot) and transverse, located at the base of the fingers. With loads, these arches seem to "spread out", but at rest they "reassemble" to their original position.
Vibrations of the body that occur during movement are absorbed by these natural springs and are not transmitted to the body. The springy condition of the foot is achieved through the ligaments of the foot and the muscular skeleton of the shin. Proceeding from this, it is possible to single out the following functions of the foot:
- depreciation of the body weight during the movement;
- providing support by projecting the body weight onto the foot;
- keeping balance and static position in a standing position;
- Perform acceleration of the body while driving. A print of the arches of the foot.
If the arches of the foot are flattened, then none of the above functions can be performed. Flattening is longitudinal, transverse, but the greatest problem is the combined flat feet, in which there are signs of these two types of deformation.
According to statistics, more than 50% of the world's population suffer from flatfoot in one form or another, and this sad fact depresses. After all, the effects of flat feet can seriously damage a person's condition, and the disease in some cases can be treated only in an operative way. These include intervertebral hernia, valgus deformation of the foot, scoliosis and many other pathological conditions.
Flat-footedness can be congenital and acquired. Congenital deformity of the foot is very rare in newborns, and treatment for such children is prescribed from the first day of life. But the modern image and pace of life impose an imprint on the formation of posture and foot, especially in children.
The causes of flatfoot in children and adults are as follows:
- incorrectly matched shoes;
- deficiency of nutrients in the body;
- injury and heavy physical exertion( during pregnancy, wearing high heels, lifting weights);
- insufficient physical activity;
- "standing" work and enthusiasm for some sports;
- excess weight.
Signs and symptoms
Among the acquired forms of flatfoot, several species are distinguished, which differ in etiological character. Types of flatfoot are as follows:
- static - occurs in 80% of all cases of the disease;
- rachitic - occurs due to transferred rickets;
- traumatic - occurs after trauma;
- is paralytic - after poliomyelitis or paralysis of the muscles of the lower leg and thigh.
Early symptoms of
- Shoe shape change and premature wear on the inside.
- Pain when walking and wearing high heels, as well as during a long standing position.
- Pain in the area of the feet that appear during exercise.
- Puffiness and cramps in the legs( especially in the evenings).
- An increase in the foot( both in length and width), which is the reason for the increase in foot size.
- Pain in the lumbar region and headaches.
- Change gait to a clubfoot.
- The appearance of a bone on the thumb.
- Curvature of the shape and length of fingers, ingrown nails.
- Appearance on the sole of corns and heel spurs. Deformity of leg joints( ankle and hip).
But these symptoms can occur in other diseases, for example, with varicose veins. In addition, longitudinal and transverse platypodia have a number of symptoms that are specific and appear only with a specific form of the disease. By these signs it is possible to determine the form of the disease.
Longitudinal flat feet
- Puffiness in the back of the foot and pain when pressing in the middle of the foot.
- Sharp back pain, worse with walking.
- Spreading heel and flattening of the longitudinal arch.
- Disturbance of ankle mobility.
- Impossibility to pick up shoes for serial production.
Degrees of longitudinal flatfoot.
- Compaction and gradual disappearance of the arch between the fingers.
- Deformation of fingers( resembling hammers).
- Pain localized in the area of the fingers.
- Appearance of calluses on the outside of the foot.
Degrees of transverse flatfoot
Treatment of flatfoot always depends on the severity and severity of the disease. There are three degrees of flatfoot.
- First degree or weakly expressed - patients complain of pain, swelling, decreased plasticity, especially with physical exertion.
- The second degree - there is a flattening of the arches, pains in the leg, up to the knees, as well as difficulty in walking are aggravated.
- The third degree or pronounced - it is at this stage that the patients finally seek help, since most of the symptoms appear. The pains with flatfoot in this case are so sharp that they are the main reason for going to the doctor.
As already mentioned, the optimal treatment of the disease at the age of 6-7 years. Already at the age of 12-13 years, treatment of adolescents is a certain complexity, because the bone system is almost formed. Adult treatment is further complicated, and conservative methods are used only at 1 and 2 degrees of the disease. The presence of 3 degrees of flatfoot, severe pain and progressive deformation of the foot serve as direct indications for surgical intervention.The goal of conservative treatment is to reduce pain, strengthen the ligaments and muscles of the foot, and stop the degenerative-dystrophic changes in the foot and other body systems. Conservative treatment is always performed in conjunction with physiotherapeutic and medicamental methods. A huge role in the treatment have such methods of therapy as exercise therapy and therapeutic massage.
Exercises should be performed every day, and the types of exercises are selected strictly by the orthopedist physician individually. When selecting a doctor, he takes into account the degree of deformation and type of disease, the age of the patient and the presence of concomitant diseases.
In conclusion, it should be noted that the selection of shoes and insoles for patients is of great importance( especially for children).All orthopedic adaptations should not only adjust the shape and function of the foot, but also reduce pain.
Transverse platypodia is a disease that occurs mainly in older people. To characterize the disease, the term transversely spreading foot is also used. The development of this pathology is directly affected by the condition of the plantar aponeurosis. This dense connective tissue film that runs from the calcaneus to the bases of phalanges of the fingers. To correct a transversely spreading foot, modern medicine is not able. At the moment there are no methods that restore ligaments and fascia, which for a long time were subjected to stretching.
If in the process of walking or standing at least half of the body weight falls on the first metatarsal bone connecting with the thumb of the foot, this is the norm. In this case, weaker loads fall on the average metatarsal bones, and quite small ones on the fourth and fifth bones. In patients with transverse flatfoot, the load is distributed quite differently, and the second and third fingers have to bear the main burden. In this case, the first finger accounts for less than fifteen percent of body weight.
With a transversely spreader foot, there are other pathologies. The first metatarsal bone rotates about its axis and ends up higher than it should be in the norm. Smaller bones, which should be located under the first metatarsal, move to the outside of the thumb so that they can be palpated. The thumb, as well as the little finger, also deflects outwards.
- Transverse flatfoot 1 degree - the angle between the first and second metatarsal bones is ten to twelve degrees. The first degree of transverse flatfoot usually manifests itself in periodic pain in the feet, especially in the anterior part.
- The transverse flatness of the 2nd degree is characterized by an increase in the named angle to a mark of fifteen degrees. The second degree brings pains localized under the heads of mid-metatarsal bones.
- Transverse Platypodia 3rd degree - the angle is further increased, to twenty degrees. The third degree makes itself felt by constant and severe pains under the heads of metatarsal bones, in the same place, as a rule, significant corns are formed.
Degrees of transverse flatfoot
The clinical picture of transverse flatfoot is such that it is not difficult to recognize the disease. With prolonged walking in the uncomfortable shoes of a man with a transversely spread foot, the pain in the area of the first metatarsal bone periodically disturbs. Unpleasant sensations can also appear spontaneously, mostly in the evenings. This is due to inflammation in the joint bag of the first metatarsophalangeal joint. The joint swells, and the skin around it blushes.
The transversely spread foot is easy to identify when viewed: it has a very distinctive appearance. Errors in diagnostics are practically excluded. For transverse flatfoot, the nasolids are characteristic, which are located below the base of the fingers. Immediately striking and deviation of the thumb.
For the treatment of transverse flatfoot, both conservative and surgical methods are used. Conservative is used with a slight degree of transverse flatfoot and deviation of the big toe. In this case, patients must necessarily wear special orthopedic shoes, limit the length of stay in an upright position. Physiotherapeutic procedures, massage and therapeutic gymnastics are very effective.
In those cases where the transversely spreading foot is expressed in medium or high degree, there is no way to do without surgical methods of treatment. In modern medicine there are about one and a half hundred different methods, while none of them can not be called absolutely perfect.
The essence of almost all of them consists in excision of fragments of metatarsal bones, which are given the correct configuration. During the postoperative period, patients are assigned the use of gypsum longi, which is applied to the leg up to the upper third of the shin.
It is necessary to wear a longet for two months. After it is removed, it is time for restorative treatment. It consists of physiotherapy procedures, massage, as well as physiotherapy. The pledge of the absence of serious consequences of transverse flatfoot is the timely treatment begun. Surgical intervention completely eliminates the existing deformation.
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