Deutschland disease is damage to the metatarsal bones. Pathology is named after the doctor who described this ailment in 1921. The disease occurs due to increased stress on the legs. It is characterized by changes in bone structure. Identifying such a disease is sometimes quite difficult. Sometimes, even experts mistakenly diagnose this disease as osteomyelitis or a bone tumor. This pathology is also called the marching foot, as it is often found in young soldiers after long marching throws.
Pathogenesis
The plus is called the middle part of the foot. It is located between the tarsus and the fingers. This section of the lower extremity consists of five bones and experiences the greatest load when standing up and walking.
In Deutschland’s disease, bone remodeling and partial resorption occur. The second and third bones of the metatarsus are usually affected, since they have the greatest load. On an X-ray, the changes look as if one part of the bone was partially separated from another. Therefore, the disease is often called a marching fracture.
However, this pathology does not occur as a result of trauma. When it does not completely break off the bone. This disease only looks like an incomplete fracture. Over time, the affected areas are closed with normal bone tissue. Therefore, many experts consider the term marching fracture obsolete.
X-ray changes in this pathology can be seen in the photo below.
Risk group
The disease most often develops in patients with flat feet. Also at risk are people whose activities are associated with increased load on the legs:
- recruiting soldiers;
- Tourists
- athletes;
- dancers;
- guides;
- waiters
- hairdressers.
Wearing uncomfortable shoes can provoke a Deutschland disease. Pathological changes in the metatarsal bones are often observed in women wearing high-heeled shoes.
This disease often develops in untrained people. In a person who is not accustomed to intense physical exertion, pathology can occur even after systematic long walks.
Symptomatology
The acute form of the disease develops 3-4 days after a heavy load on the legs (for example, a long trip or march). The patient has pain in the foot and swelling above the bones of the metatarsus. Unpleasant sensations can be quite intense.
The primary chronic form of the disease is more common. Symptoms of bone damage in this case gradually increase. At first, the pains are mild and do not interfere with movement. The patient often wonders why the foot hurts, because he had no injuries.
Over time, the pain becomes intense and unbearable. The patient begins to limp. A person tries to step on the injured limb as little as possible due to pain in the foot. A swelling on top of the metatarsus looks like a dense swelling. When you click on it, pain is noted.
Very rarely, slight redness of the skin is observed in the area of edema. At the same time, the general well-being of the patient is not disturbed, there is neither high fever, nor weakness.
Such symptoms may bother the patient for 3-4 months. Then the pain subsides, and the pathology ends in recovery. The changed areas of the metatarsus are tightened with normal bone tissue. We can say that this disease always ends with self-healing and does not cause complications. However, neglect of therapy is still not worth it. Pain with this pathology can be very severe. Often, the patient cannot move normally due to unpleasant sensations.
Diagnostics
The treatment of this pathology is performed by a traumatologist or orthopedist. The most reliable diagnostic method is an X-ray of the foot. The following changes can be seen in the picture:
- At the beginning of the disease, changes in the structure of bone tissue are visible. You can see the oblique or transverse light strip. It is in this area that pathological bone remodeling takes place. It is very much like a fracture. The bone seems to be divided into two parts. However, unlike a real fracture, tissue displacement is not observed.
- In the future, overgrowth occurs around the lesion site, and then bone marrow is formed. The light bar gradually disappears.
- At the stage of recovery, bone marrow is absorbed. However, the bone remains thickened.
An important role in the diagnosis of the disease is the collection of anamnesis. It must be established that in the past the patient had no injuries to the limbs.
Radiological signs of bone damage may be absent in the first days and even weeks of the disease. Therefore, the examination is recommended to be repeated several times.
Treatment methods
Unlike a true fracture, in case of Deutschland’s disease, no casting is required. However, it is necessary to temporarily limit the load on the legs.
The patient is recommended to observe bed rest for 8-10 days. On a diseased limb, a langeta is put on for a period of 1 month. This provides peace of the foot and promotes the rapid healing of damage.
With severe pain, analgesic ointments and gels are prescribed:
- Troxevasin;
- "Gevkamen";
- Efkamon;
- Bom Beng;
- Boromenthol.
The use of warming local products is not recommended. In this case, they exacerbate the discomfort.
After removal of the bandage, the patient is prescribed a course of physiotherapy. Shown massage, warm foot baths, applications with paraffin on the metatarsus. In the future, patients are advised to use insoles for shoes and avoid excessive stress on the lower limbs.
Prevention
We can conclude that this disease is easily cured and does not give complications. However, it significantly reduces the quality of life of the patient. Therefore, measures must be taken to prevent pathology.
If a person’s activity is associated with a load on his legs, then you need to periodically undergo a course of therapeutic massage. At home, it is useful to do foot baths after a working day. For long walks, wear comfortable low-heeled shoes. Recruit soldiers need to be regularly examined by an orthopedic surgeon. This will help prevent damage to the metatarsal bones.