splayfoot
| Classification according to ICD-10 | |
|---|---|
| M21.6 | Other acquired deformities of the ankle and foot |
| Q66.8 | Other congenital deformities of the feet |
| ICD-10 online (WHO version 2019) | |
Under splay (Pes transversoplanus) apart points of the bones of the beams is midfoot understood. A “small arch of the foot” or “transverse arch”, which should normally be formed in the area of the forefoot, has been penetrated, so that a callus is often clearly visible below the metatarsophalangeal joints of the second and third toes. Today we know that the "transverse arch" is not only maintained by ligaments, but also by muscles, and the like. a. through the ball muscles.
causes
The reason for splayfoot is not a lack of exercise, but mostly the wearing of unsuitable footwear, especially high heels. The forefoot load is fivefold in high-heeled pumps. In addition, the weakness of the connective tissue (mainly in women - genetic disposition) is another reason why the forefoot can widen. In addition, the padding of the soles of the feet can flatten out with increasing age, so that the metatarsal heads 2 to 4 are included in the load.
Calluses always arise on parts of the body with high stress. Normally, a foot is loaded at the heel, the outer edge of the foot, under the 1st and 5th metatarsal heads and under the big toe. With splayfoot, the metatarsal heads 2–4 are burdened, causing calluses (so-called transverse arches).
Risks
Normally the splayfoot causes few problems. However, it is a risk indicator for developing hallux valgus when wearing pointed and / or high-heeled shoes. The latter, in particular, cause the metatarsal bones to be pushed apart by drastically shifting weight on the forefoot. If shoes are often worn that point forward and press the toes together, the tendons no longer run over the metatarsophalangeal joints, but further inside, pulling the toes further and further into a crooked position. Toes that are tightly together are a typical late consequence of splayfoot. Due to the chronic irritation of the plantar nerves, an interdigital pain syndrome (so-called Morton's neuralgia ) can develop.
prevention
Hallux valgus and hammer toes are not only a cosmetic problem, they usually cause long-lasting complaints. Anyone who determines that they are predisposed to splayfoot is therefore well advised to wear flat shoes with space for the mobility of the toes.
Especially in children and adolescents, splayfoot and other misalignments can be prevented by frequent barefoot walking . High-heeled shoes are largely avoided.
treatment
If pain and calluses occur under the middle metatarsal head while running, the transverse arch should be raised again with a pad (retrocapital support). This pad can be incorporated into an insert, but it can also be built into the shoe by the orthopedic shoemaker or glued into the shoe as an adhesive pad. However, this further restricts the movement of the foot, which although the symptoms are alleviated, the muscles are not strengthened. A permanent solution - provided there is no contraindication or other cause - is only offered by slowly building up the foot muscles, for example by walking barefoot and then walking barefoot .
In acute cases, a splayfoot bandage can be used.
