Deformities
Causes
There are several kinds of foot deformities, e.g. Cavus foot (Pes cavus), a foot with a high arch which fails to flatten with weight bearing, or flatfoot (Pes planus).
Pes cavus
Underlying hereditery diseases are frequent. In presence of severe toe deformities a muscle or nerve pathology has to be ruled out. Using orthotic devices spots of painful pressure may be relieved.
Surgical correction has to be considered in case of rapidly increasing deformity and/or deterioration of the walking capacity.
Procedures mainly consist of osteotomies (cutting bones), arthrodeses (permanent immobilization of joints), and transfer of tendons.
Flatfoot
The longitudinal arch collapses and the heel deviates off the body midline to the lateral side.
This deformity may be due to significant shortening of the muscles of the calf which results in equinus deformity. Compensation is achieved by development of a flatfoot.
In the adult partial or complete rupture of the tendon of the posterior tibial muscle may cause painful flatfoot deformity. This tendon is located behind and below the inside of the ankle.
Symptoms
Pain and swelling along the posterior tibial tendon.
Therapy
Treatment of the inflammatory process around the tendon is essential to prevent rupture. Non-weight bearing, orthotic devices, strong and stable footwear and local anti-inflammatory treatment. At times immobilization with a cast may be necessary.
Surgical Procedures
In most cases it is possible to preserve joint function of the hindfoot. However, if severe deformity or advanced joint degeneration is present, correction and stabilization by arthrodesis of single or multiple joints may be necessary.
|
 |
Pes planus
Pes cavus
Posterior tibial tendon
|
