Flat foot
| Classification according to ICD-10 | |
|---|---|
| M21.4 | Flat foot [Pes planus] (acquired) |
| Q66.5 | Pes planus congenitus |
| ICD-10 online (WHO version 2019) | |
The flat foot (lat. Pes planus ) is a congenital or acquired foot deformity , wherein said longitudinal arch (the curvature from the heel to the front foot pads) of the foot appears to sink. As a result, the heel can tilt towards the outer edge of the foot and the forefoot can also tilt towards the outer edge of the foot. In extreme cases, the foot surface rests completely on the floor. A less pronounced form of the acquired flat foot is the arched foot , in which the longitudinal arch only pushes through to the ground when the foot is loaded.
Often there are complaints on the inner edge of the foot in the area of the scaphoid and the sole of the foot. Sometimes be pain in the calves , the knees , the thighs , the hip and cross sued. With a developed flat foot, there is usually no more pain.
Congenital flat feet
The innate flatfoot (lat. Pes planus congenitus , also: congenital flat foot , talus verticalis , obsolete: rocker- , Tintenlöscherfuß ) is rare and occurs in about 50 percent of all cases in combination with other malformations. The sole of the foot appears to be rounded outwards (convex), the tarsal bones are shifted towards the sole of the foot, the Achilles tendon is shortened, the forefoot appears splayed (forefoot abduction) and dorsally extended. In the radiograph in congenital flatfoot a steep posed ankle bone ( talus verticalis to see). In addition to a gradual reduction in plaster of paris in infancy, surgical therapy and subsequent care with orthopedic insoles or orthopedic shoes are often necessary.
Acquired flat feet
The acquired flatfoot arises in most cases by a decreased function of the tibialis posterior , which may in children and young adults be too weak or old age often have wear that to tendonitis , tendon attachment ( enthesopathy ) and crack can cause the tendon.
The cause can be a lack of training (long-term sitting, constant wearing of shoes), overstressing the foot, for example due to obesity or prolonged standing, weak connective tissue , fracture of the heel bone (post-traumatic flatfoot) and diseases such as polio , rickets and neurological and rheumatic diseases. The ankle bone is in the normal position in the X-ray.
In hemiplegics , after the initial equinus foot position under body weight load, a flat arched arched foot deformity (so-called "spastic flat foot") can occur.
The so-called “contracted flat foot” is mostly caused by a connection between the heel and scaphoid bones, less often between the other bones of the back and metatarsus.
treatment
With children and adolescents one tries to get along without orthopedic aids at first. We recommend doing foot exercises, walking barefoot and suitable shoes with soft soles.
Physical strengthening of the lower leg and foot muscles is also important for adults. Furthermore, insoles and, in severe cases, orthopedic shoes are prescribed. In some cases, surgery may also be indicated.
See also
Web links
Individual evidence
- ^ Gerhard Fleischner: Podological orthopedics . Verlag Neuer Merkur, 2003, ISBN 978-3-929360-89-9 , pp. 77–.
- ^ A b Klaus Buckup: Pediatric Orthopedics . Georg Thieme Verlag, 2001, ISBN 978-3-13-697602-9 , pp. 185–.
- ↑ Orthopedics for Pediatricians . ( Memento of the original from July 5, 2010 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF)
- ↑ Surgical correction of the child's flat foot . ( Memento of the original from June 26, 2010 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ^ Renate Wolansky: Illnesses in podiatry: anatomy, imaging diagnostics, therapy . Georg Thieme Verlag, 2006, ISBN 978-3-8304-5348-2 , p. 37–.
- ↑ Medical Tribune , Vol. 39, No. 3 ( Memento of the original from July 5, 2010 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 154 kB) January 16, 2004, p. 10
