Sickle foot
| Classification according to ICD-10 | |
|---|---|
| Q66.2 | Pes adductus (congenitus) |
| M21.6 | Other acquired deformities of the ankle and foot |
| ICD-10 online (WHO version 2019) | |
The sickle foot ( pes adductus ) is a common, mostly congenital, less often acquired misalignment of the foot in which the forefoot deviates inwards or medially , is "adducted". This misalignment often occurs on both sides and can be associated with other foot malpositions, such as an increased arching of the longitudinal arch, the arch of the foot . The sickle foot is also a component of the club foot . Other misalignments can also be associated, such as hip dysplasia .
The cause of this misalignment is believed to be a fixation of the foot position due to the position of the fetus in the (narrow and round) uterus. The diagnosis is often made immediately after birth or at U3 .
therapy
In addition to the strength of the misalignment, it is crucial for the treatment whether the sickle foot can be corrected by light pressure (passively), or can be corrected (actively) by the baby's own strength, or is "rigid", i.e. not correctable.
Active correction can be achieved, for example, by wiping the outer edge of the foot, with the baby then spreading the forefoot and correcting it. Then reflex and stretching exercises are sufficient. The Babinski reflex is used , which spreads the toes when stroking along the side of the foot and thus stretches the foot into the straight shape of the foot through its own muscle power. During the stretching massage, the foot is carefully stretched into a straight shape several times a day.
If the child’s muscular strength cannot pull the feet into the desired straight shape via the reflex, a bandage is usually applied. In the very rare rigid forms, a corrective plaster cast is usually applied, which is changed about weekly and corrected a little more each time, until a complete correction of the rigid sickle foot is available after a few weeks.
After the bandage or plaster therapy, sickle foot orthoses are usually used for additional months. If the child is already starting to walk, anti-varus shoes can be prescribed, which further passively correct the foot and keep it in the desired position.
