flatfoot

Introduction

Flat foot introduction Flat feet are mainly due to some abnormalities in the shape of the foot bones. The flat feet caused by the relaxation of the ligaments occur in adolescents and have a genetic predisposition. The arch of the foot is a unique anatomical structure of human beings. It is adapted to the needs of long-term single standing and walking. Due to different lifestyles and environments, the height of the arch of a normal person is different. It is not the cause of flatfoot disease. Theflapfoot is formed only when the bone morphology is abnormal, muscle atrophy, ligament contracture or chronic strain is caused by some reasons. basic knowledge The proportion of sickness: 0.6% Susceptible people: no special people Mode of infection: non-infectious Complications: tendonitis, loose pain

Cause

Flat foot cause

Genetic (30%):

The etiology of this disease has not been elucidated, but epidemiological studies have found that the disease has a clear genetic predisposition. Pathological observation of the foot and ankle has no developmental malformation, but the connection distance is heel, and the ligament of the joint capsule from the boat and the scaphoid joint is normal. Relaxation, when the weight is heavy, the calcaneus is internally rotated under the talus, the front end is displaced to the dorsal side and the lateral side, and the talus is displaced to the temporal side and the medial side, which causes the slack and the scapula ligament to be looser and cannot support the talus. Lowering the longitudinal arch and lowering the ligament with the ligament, which causes the calcaneus to eversion, which aggravates the decline of the longitudinal arch. Clinically, the etiology of the disease is divided into four categories: (1) genetic factors; (2) congenital foot deformities. (3) foot trauma or chronic strain; (4) weak internal muscle or external muscle strength or paralysis, paralysis.

Congenital bone deformity (30%):

Common bone malformations include increased scaphoid nodule deformity, separation of the scaphoid or scaphoid nodule, which can reduce the support force of the posterior tibial muscle and the stability of the spring ligament, resulting in sag and introversion of the talus, plantar Eversion and so on. In addition, the first tibial short, congenital tibial bridge can also produce flat feet.

Acquired or strained (20%):

The flat arch and the load line are normal. If the muscles are weak inside and outside, the flat foot is often induced. The factors that cause muscle weakness are: systemic malnutrition; muscle weakness after a long illness; sudden increase in body weight; poor standing or walking posture, outward toe, weight line moving to the inside of the toe; shorts of the Achilles tendon, heel can not touch The load line is also moved inward. In the above various situations, plus infection, inappropriate shoes, ankle sprains, sudden excessive weight bearing or long journeys, beyond their own endurance, muscle ligaments are bound to be pulled and produce severe pain in the feet, obvious edema and muscles in the feet. Hey, initially the acute foot strain, that is, the pain of the arch of the foot, fatigue, after rest, physiotherapy, etc. to improve blood circulation, you can return to normal. If improperly treated, there will be long tendon of the humerus, foot abduction, valgus deformity, foot adduction, varus activity reduced, and the foot is strong enough to be valgus. Finally, traumatic changes in the bones and joints occur. This type is also known as spastic flatfoot.

Prevention

Flat foot prevention

The prevention of this disease mainly includes the following aspects: First, children should be encouraged to participate in appropriate physical exercise, so that their muscles and ligaments can be properly stimulated. Activities such as skipping, high jump, and long jump can make the arch more effective. Good exercise, when doing physical exercise, should wear soft-soled shoes as much as possible, it is best to wear professional sports shoes, and should not let children wear too small shoes. For babies up to 9 months, don't let him go too early, and don't stand for a long time. After the eleventh and the second year of age, although the child is in a rapid growth period, the development of muscle strength is slower than the bones. Therefore, do not He is tall and often arranges to work for adults. If the flat foot is already obvious, the child can practice walking with the toes or the outside of the foot, and a certain corrective effect can be obtained. The flat foot that cannot be corrected should go to the orthopedic department of the hospital for correction.

Complication

Flat foot complications Complications, tendonitis, relaxation, paralysis

Complications of flat feet usually occur after puberty. Due to the rapid increase in body weight and activity, the soft tissue of the foot is repeatedly subjected to excessive load, resulting in chronic foot muscle strain, tendonitis (especially after Muscle tendonitis), plantar fasciitis, pain and other complications, severe cases can also cause osteoarthritis.

Symptom

Flat foot symptoms Common symptoms Joint pain Low back pain Foot pain Foot swelling Stomach Fatigue Knee pain Pain footsteps Foot soles Foot and foot edema

Clinically, it is divided into posture flatfoot disease and spastic flatfoot disease.

1. Postural flatfoot disease: For the initial stage, the appearance of the arch is not abnormal, but after walking and tired, feeling tired and painful, pain in the lateral part of the calf, swelling in the center of the foot and instep, scaphoid The swelling and tenderness of the joints are obvious. The local skin can be reddened, and the foot movements are mildly restricted. When standing, the feet are flat and the feet are everted. After the rest, the symptoms and signs can disappear.

2. Spastic flatfoot disease: occurs in young adults, partly due to improper development of posture and flat foot, mainly for standing or walking when the pain is severe, can be a squat gait, the long bone of the humerus is tonic, foot Internal, valgus and abduction activities are limited, the heel is widened, the plantar is everted, the Achilles tendon is outwardly deflected, the forefoot is abducted, the scaphoid nodule is completely collapsed, and protrudes inward. In severe cases, the foot is stiff. Fixed to valgus, abduction and back extension, the activity is obviously limited, even after a long rest, the symptoms are difficult to improve, some patients may suffer from low back pain and hip and knee pain.

Clinically, according to the severity of the disease, the disease can be divided into three types, but the changes of the longitudinal arch should be observed when the weight is heavy:

1, light: the foot longitudinal arch is lowered.

2, medium: the longitudinal arch disappears.

3, heavy: the longitudinal arch disappears, and the medial edge of the foot is raised, the talus is displaced to the front of the ankle, ie the anterior and posterior iliac crest. The patient sometimes has achilles tendon shortening and hindfoot valgus.

Examine

Flat foot examination

The auxiliary examination method of this disease is mainly X-ray examination. The X-ray examination should take the positive lateral X-ray film under the weight bearing condition, and the angle of the arch is measured mainly in the foot side piece.

1 draw a straight line along the distance, the boat, the first clavicle and the long axis of the humerus, and then draw a line equal to the front and rear articular surface in the center of the scaphoid, and intersect with each line. Usually the two lines of the arch are at right angles. Intersection, if the lesion or ligament relaxation occurs in the scaphoid joint, the scaphoid, the first clavicle and the humerus axis and the talus central axis are not continuous, and form an angle on the ankle side, the talus axis is passed through the scaphoid side 1 /4, if the ligament relaxation occurs in the scaphoid joint, the talus central axis is located on the temporal side of the first cuneiform bone, and intersects with the perpendicular angle of the scaphoid center at the right angle, and is extended when the scaphoid center is straight forward and backward. The talus and the temporal side of the first metatarsal showed ligament relaxation from both the scaphoid and the scaphoid.

2 talar flexion angle: draw a horizontal line along the lateral aspect of the ankle and intersect the central axis of the talus. The normal value is 26.5°±3.5°. When the talus has a plantar flexion deformity, the angle increases.

3 From the back angle of the boat: On the positive position of the weight, draw a parallel line along the distal joint of the scaphoid, and then draw a central axis of the talus. The inner corner formed by the intersection of the two lines is called the back angle of the boat. The normal value is normal. 60 ° ~ 80 °, this angle > 60 ° indicates a talus displacement.

Diagnosis

Flat foot diagnosis

diagnosis

1. Some patients have a family history or a history of congenital foot deformity or trauma.

2. Pain or discomfort in the foot when standing or walking for a long time, flattening with the valgus foot, valgus of the forefoot, swelling and tenderness at the scaphoid nodule, rest can be alleviated or disappeared, and the lower part is squatting and rested for a long time. The symptoms are also difficult to improve.

3. Standing position X-ray foot positive lateral slice can be seen that the scaphoid nodule completely collapses, and the distance from the load-distance protrusion increases, from the bottom of the calcaneus nodule to the bottom of the first talus, and from the scaphoid nodule The line is a vertical line and its length is less than 1cm.

Flat feet have two major categories: primary and secondary. When diagnosing primary flat feet due to ligament relaxation, careful diagnosis should be done carefully, except for the scaphoid deformity, the first metatarsal shortening, congenital The flat feet that are complicated by clubfoot varus are also excluded from neuromuscular diseases such as paralytic flat feet caused by poliomyelitis, and spastic flat feet caused by cerebral palsy. According to the age of onset, detailed medical history and physical examination, X Line inspection can make a correct diagnosis.

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