flat feet
Introduction
Brief introduction 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 Sickness ratio: 5% Susceptible people: no special people Mode of infection: non-infectious Complications: Traumatic arthritis
Cause
Flat foot cause
Genetic factors (30%)
After birth, there are flat feet and weight-bearing lines, which are generally asymptomatic. Only when the level of flatness is serious or the objective conditions are unfavorable, the symptoms appear, gradually becoming lighter and heavier, resulting in traumatic changes in the joints of the feet and reduced joint activities. So that it disappears, in this case, one or both of the parents may have flat feet.
Congenital bone deformity (20%)
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, etc. In addition, the first metatarsal bone, congenital iliac bone bridge can also produce flat feet.
Foot muscle weakness (20%)
Normal foot arch and load line are normal. If the muscles are weak inside and outside, the flat feet are often induced. The factors causing the weakness of the foot muscle are: systemic malnutrition; muscle weakness after a long illness; sudden increase in body weight; poor standing or walking posture, The toe is outward, the weight line is moved to the inside of the toe; the Achilles tendon is shortened, the heel cannot be grounded, the load line is moved inward, etc. In the above various cases, infection, shoes are not suitable, ankle sprain, sudden excessive Weight-bearing or long-distance trek, beyond its own endurance, muscle ligaments are bound to be pulled and produce severe pain in the foot, obvious edema and muscle spasm in the foot, initially acute foot strain, ie arch pain, fatigue, rest, physiotherapy, etc. After improving blood circulation, it can return to normal. If improperly treated, there will be long bone spasm of the humerus, foot abduction, valgus deformity, foot adduction, varus activity reduced, the foot is straightened to the valgus position, and finally the bone and joint trauma occurs. Sexual change, this type is also known as spastic flatfoot.
Prevention
Flat foot prevention
Perform functional exercises on the internal and external muscles of the foot, such as walking on the ankle, flexion movement, and external rotation. At the same time, choosing shoes with good arch support and avoiding standing for a long time have certain significance for the prevention of flat feet.
Complication
Flat foot complications Complications, traumatic arthritis
Trauma arthritis of the lower extremities can be caused by the inability to absorb shock.
Symptom
Flat foot symptoms Common symptoms Tired traumatic foot and edema of the foot
Postural flat foot
In the early stage of the disease, the appearance of the arch is not abnormal. Only after standing and walking for a long time, the foot is tired, sore, and the foot and the back of the foot are swollen. Generally, it can completely disappear after rest.
2. flat bottom foot
In the mid-stage of the disease, it is caused by the development of the posture flat foot. It is mainly manifested by the temporal muscle group, the foot is everted, the abduction and the dorsal extension, the arch of the foot is collapsed, the pain is aggravated, and the walking and standing are not durable. Can not be completely relieved after a break.
3. Tonic flat foot
That is, in the late stage of the disease, the above two types of treatment are improperly developed. The sacral tendon muscle develops to be strong and straight, and the interphalangeal ligament is also strong, so that the foot is fixed in eversion, abduction and extension, the arch disappears, walking and standing Difficulties, but the pain is relieved. Because the normal function of the foot disappears, the shock can not be absorbed, and pain can occur due to traumatic arthritis of the other joints of the lower back and lower limbs.
Examine
Flat foot examination
X-ray films can show the following bone and joint deformities.
1. The first clavicle and the first metatarsal are separated from the midline (biased inward).
2. The overlap with the heel is characterized by crossbar damage.
3. The gap between the first wedge bone and the first metatarsal bone disappears, which is manifested as talar inversion and calcaneus valgus.
4. Subluxation of the interphalangeal joint.
5. Hallux valgus.
6. The apex angle is 105°~120°.
7. The arch index is less than 0.29, and the weight can be less than 0.25.
Diagnosis
Flat foot diagnosis
diagnosis
According to the clinical symptoms, signs and the above X-ray examination can confirm the diagnosis, the foot print examination shows that the sole of the foot is completely ground, and even protrudes to the inside.
Differential diagnosis
The flat foot should be distinguished from the flat foot:
1. The flat foot is mainly characterized by the disappearance of the arch of the foot. In addition, most patients have no obvious discomfort. A small number of patients have pain in their feet after standing or walking. According to the cause, it can be divided into three types:
a. Flexible flat foot: Most flat feet are flexible and flat feet. There is a normal arch in the non-weight bearing state, and the arch disappears after the weight is loaded.
b. Stiff flat feet: the arch of the foot is flat under non-weight bearing conditions. It is caused by joint deformities such as scaphoid, calcaneus and talus.
c. Flat foot caused by the scaphoid: due to the presence of the scaphoid bone changes the position of the posterior tibial tendon, this abnormal anatomical relationship leads to the flat arch.
2, flat foot arch is not necessarily flat foot disease, but the arch of the flat foot is always low, and there is foot eversion, elasticity disappears in the long standing or walking when there are pain symptoms. There are many causes of flatfoot disease, which are roughly divided into the following categories:
a. Postural flat foot is the initial stage of the disease, the appearance of the arch is not abnormal. Only after standing and walking for a long time, the foot is tired, the sore sole and the back of the foot are swollen, and generally disappear after the rest.
b. The genital flat foot is the development of the posture of the flat foot in the middle of the disease, mainly manifested as the temporal muscle group, the foot is valgus, abduction and dorsal extension, the arch is collapsed, the pain is aggravated, walking and standing They are not durable and cannot be completely relieved after a break.
c. The tonic flat foot is the late stage of the disease, which is improperly developed by the above two types of treatment. The sacral tendon muscle develops to be strong and straight, and the interphalangeal ligament is also strong enough to fix the foot in eversion, abduction and dorsal extension. The arch of the foot disappears. The difficulty in walking and standing is relieved. Because the normal function of the foot disappears, the shock can not be absorbed. Pain can occur in traumatic arthritis of the lower extremities and other joints of the lower extremities.
