What is a hollow foot? You can find a photo of this pathology in the presented article. Also, we will determine the disease in question, identify the causes of its occurrence, list the symptoms and talk about treatment.
basic information
What is a hollow foot? This is a pathology involving the deformation of the lower extremities. It is characterized by lowering the tips of the fingers down and raising the heel up. Due to this deformation, the size of the arched arch significantly increases in the patient.
Hollow foot can be a hereditary disease, and also develop with age (from 35 years). The disease in question is the opposite of flat feet.
Deformation stages
What does hollow foot treatment depend on? Experts argue that the choice of a particular therapy is directly related to what stage this disease is at. Specialists distinguish 2 stages of deformation:
- At the very beginning of the disease, a change in the soft tissues (morphological) occurs. In order to eliminate this problem, doctors recommend that the patient provide pressure on the head of the first metatarsal bone.
- If measures to treat the developed deformity have not been taken, then a stable phase of the disease occurs, which requires urgent medical intervention.
Causes of occurrence
Why does a hollow foot develop? The reasons and the exact mechanism for increasing the arch arch have not yet been clarified. However, doctors suggest that such a pathology may occur due to imbalance (muscle) against the background of hypertonicity or the weakening (paretic) of individual muscles of the foot and lower leg. By the way, some experts note that sometimes when examining a patient with the deformity in question, it is not possible to confirm a marked decrease or, on the contrary, an increase in muscle tone.
According to most doctors, most often the hollow foot is formed due to pathology of the neuromuscular system and a number of diseases, as well as muscle dystrophy, polio, spinal dysraphia, Charcot-Marie-Tooth disease, syringomyelia, polyneuropathy, Friedreich's ataxia, cerebral palsy, meningitis, meningoencephalitis, benign and malignant tumors of the spinal cord.
Very rarely, such a pathology develops due to burns of the lower extremities or improperly fused talus and calcaneus (after fractures).
In 20% of all cases, the factors that triggered the hollow foot remain unclear.
Symptoms of the disease
In pharmacies and medical centers, hollow foot insoles are often sold. What are they needed for? The fact is that such a disease does not pass for a patient without a trace.
With an increase in the arch arch, the patient constantly complains of pain in the feet, fatigue during walking and discomfort in the ankle joints. Also, some patients note that they have great difficulty choosing comfortable shoes.
When examining a person with the pathology in question, experts identify an increase in the height of the inner and outer arch, flattening, expansion and a small reduction of the front of the sole, painful corns (for example, at the base of the first finger and in the little finger area), as well as deformation of the fingers. In addition, such a patient quite often has pronounced stiffness of the foot.
Other symptoms
The hollow foot, developed as a result of poliomyelitis, may be accompanied by an unsharp one-sided paresis in combination with the equinus of the foot. In this case, the tone of muscle tissue is reduced, and the deformation does not progress.
If a person has cerebral lesions, then he may have spastic effects, increased muscle tone and increased reflexes (tendon). Such a process is not progressive and one-sided.
With congenital malformations, the pathology is usually bilateral. It is prone to progression, especially during periods of active growth (for example, at 5-8 years and at 11-15).
With a diagnosis of Friedreich’s disease, the hollow foot is 2-sided and progressive. Usually, family members of the patient also have cases of this disease.
An increase in the arch of the foot is often combined with ataxia and impaired gait. In addition, mild disorders of sensitivity and damage to the pyramidal pathways are characteristic of such a disease .
In Charcot-Marie-Tooth disease , a person has 2-sided and progressive deformation of the feet, as well as muscle atrophy, which spreads from the bottom up.
How is it diagnosed?
Exercises with a hollow foot should be performed. However, this should be done only after the diagnosis has been clarified by an experienced doctor. As a rule, for this purpose, the patient is sent for plantography and radiography of the foot.
With a mild deformation on the plantogram, a large deepening of the concave arc of the inner edge is revealed, as well as a protrusion along the outer edge of the foot. With moderate pathology, concavity is observed to the outer edge. As for the pronounced disease, the imprint of the sole of a person is divided into 2 parts.
There are also neglected cases when the contours of the fingers completely disappear from the footprint. This is due to their claw-like deformation.
If the doctor believes that the cause of the problem is a disease of the neuromuscular apparatus, then the patient is referred to a neurologist. The latter conducts a detailed neurological examination, performs x-ray of the spine, MRI and CT, as well as electromyography and other studies.
With old injuries of the bones of the tarsus, the patient may need a CT scan of the foot.
If the hollow foot was detected for the first time and at the same time the patient has no diseases of the neuromuscular system, as well as no previous injuries, then this indicates a possible tumor of the spinal cord. In this case, the person is sent for examination to an oncologist.
How to treat?
The tactics of hollow foot therapy is determined by the cause of its development, as well as the degree of increase in the arch arch and the age of the patient.
With moderate and weakly expressed pathologies, the patient is prescribed physiotherapy, physiotherapy and massage. Unfixed forms of this disease can be conservatively corrected by wearing special shoes with a raised inner edge.
A severe fixed disease, especially in adults, is subject to surgical treatment.
Depending on the type of pathology and the reasons for its development, arthrodesis, osteotomy, crescent or wedge-shaped resection of the tarsal bones, transplantation of tendons and dissection of the plantar fascia can be performed. Various combinations of these techniques are also used.
Surgical intervention
The operation to restore the foot is performed as planned under conduction anesthesia. The best option is combined surgery according to Chaklin or Kuslik. The latter method involves open dissection or reduction of plantar aponeurosis together with a sickle or sphenoid resection of the cuboid bone. As soon as the resected area is removed, the back of the feet are bent in the direction of the sole, and the front to the rear. After this, the wound is sutured, drained, and gypsum is applied to the lower limb, which is not removed for 6-7 weeks.
In operations according to the Chaklin method, plantar aponeurosis is also redressed or dissected. Next, the bones of the tarsus are exposed. At the same time, extensor tendons are laid to the sides, and then a wedge-shaped resection of part of the cuboid bone and the head of the talus is performed.
As for the scaphoid, it is removed partially or completely, depending on the severity of the deformation.
With a strong prolapse of the first metatarsal bone (optional) carry out its osteotomy. When observing the equinus, a tenotomy of the Achilles tendon is performed.
In the event that the position of the foot could not be corrected during the surgical procedure, gypsum is placed on the leg for 3 weeks, after which it is removed and the final correction is made. Next, the bandage is applied again for another 4 weeks.
Insoles and exercises
Is a hollow foot treated? Insoles and correctly selected shoes are one of the easiest ways to get rid of foot deformation, as well as its prevention.
According to experts, with a hollow foot, patients need to give their preference to shoes with a wide platform and low heels. This will help to fix the leg in the correct position.
It should also be noted that buying orthopedic shoes should only be under the supervision of a treating doctor. By the way, the latter can recommend shoes with a raised inner edge. To provide proper support for the arch of the foot, orthoses are required, that is, special insoles made to order.
How to reduce the pain caused by a hollow foot? Exercises and physiological procedures for the treatment of such a disease are selected individually, on the recommendation of the attending doctor. Here are some examples:
- Starting position is sitting. The exercise is free, then with resistance (fixed weights are applied to the foot, gymnastic elastic).
- Grasping movements with fingers and both feet of various objects (wooden, rubber, metal balls of different diameters, sticks, etc.) in a certain sequence - their sizes should be gradually reduced, and weight should be increased.
- Starting position is standing. Socks inward, heels to the sides, maximum external rotation of the legs, then the transition to the outer edge of the foot. Next - lowering to the surface of the soles.
Also, to eliminate unpleasant sensations, the patient is prescribed paraffin baths, warm baths and manual correction of deformation in the form of massage.