Orthopedics-Online

Buckle foot

Introduction / General

Of the Buckle foot (Pes valgus) describes a pathological misalignment of the Foot. Here the inner (medial) Edge of the foot lowered while the outer (lateral) The edge of the foot is raised.
In addition, the heel is in an X position, i.e. the heel appears on ankle bent outwards. The buckle foot often occurs in combination with a flat foot or Flat foot on.
The articulated foot position is physiological in small children and does not require any treatment. Has the foot however, not consolidated until the age of 8 to 10 years and continues to sink inward, treatment is in the form of physical therapy necessary.

Cause of buckle foot

Buckefoot can be acquired or congenital. This is particularly common childlike arched arches. This is physiological for a certain time in childhood and is caused by the development of the feet. Due to the not yet fully developed support mechanism of the feet in children, they are forced to turn their feet inwards at the beginning of running. They unconsciously counteract this inward rotation and tilt the heel so that a buckled foot is created.

If a buckle foot develops in the course of life, it can have various causes. Reasons for this can Accidents, rheumatic diseases, spastic paralysis, Infections or overuse of the foot at unstable ligaments or massive Obesity be. Above all, however, weak ligaments in the area of the foot are the cause of a buckled foot. These cannot hold the heel upright, which means that the longitudinal arch subsides over time. Due to the overload of the feet in relation to the existing muscle strength, the ankle bone moves inwards (medial). This shifts the calcaneus slightly outwards. This makes the inner ankle appear stronger.

The talus becomes visible under the inner ankle and thus acts like a double inner ankle. This is a clear sign of the presence of a buckle foot. As a result of this changed position of the ankle bone head, the entire foot is inclined compared to the lower leg. In addition, the inner edge of the foot lowers.

Symptoms

Usually sufferers have with one Buckle foot no symptoms. In a few cases, a heavily pronounced buckle foot can become trapped in the Calcaneus and then cause massive pain in the outer ankle area.
If a buckle foot occurs at a later age, a arthrosis develop which leads to movement disorders. The child's buckled foot is usually also accompanied by no symptoms.
If pain occurs, others should always be too Misaligned feet be excluded.

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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60311 Frankfurt am Main

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Types of buckle feet

The therapeutic measures also include physiotherapy.

Flexible arched arch support:

The flexible arched arch support is the much more common variant. The transitions between pathological and normal are fluid. At the For small children, deviations from angles of up to 20 ° are still within the normal range, at School children up to 10 °. The foot is not stiffened and can be moved back and forth with your hands and brought into the normal position. When one asks the patient on the Toes, so can the Misalignment compensated the heel is now pointing inwards rather than outwards and the inner edge of the foot arches.

Causes can be weaknesses of Muscles or ligaments lie as well Obesity, Paralysis or knock knees.

The therapy is accordingly in one Strengthening the muscles through specific exercisese.g. in the physiotherapy, but often enough frequent barefoot walking on uneven terrain out. With small children, the foot often aligns itself back to its normal position by the time they start school, so that one of them good prognosis can speak with the flexible arched arches. Exceptions are flat arched feet due to bony malformations.

If the arched arched arch does not recede through training or if the form is particularly pronounced, you can also use orthopedic insoles be treated. Above all, these insoles must form a wedge-shaped support on the inner edge of the foot so that the kinking of the foot can be compensated for. Here there is Insoles for the entire foot, such as Heel cupsin which the forefoot remains free. Instead of deposits you can also orthopedic shoes be prescribed that have built-in an increase in the inner edge of the shoe.

In very rare cases, in which the flexible arch arch is very pronounced and causes pain, the Malposition also treated surgically become. Here the tendon of the anterior tibial muscle offset in such a way that the inner edge of the foot is actively straightened and the arch of the foot is restored.

Rigid arched arches:

This is a much less common misalignment of the foot at which the foot hands out of its natural position can be brought. So the joint looks stiff, one speaks of one rigid or contractile arched arches.

The causes for this can be either innate be, e.g. in form of a Malformation of the fibulathat to one altered structure of the ankle leads, or acquired. Acquired causes include, for example Changes caused by rheumatoid arthritis or accidents and other injuries. Inequalities in the interplay of muscles, e.g. at spastic paralysis, can be responsible.

The foot is diagnosed initially examined lying down, standing and walking. The patient with rigid arched arches can die No longer compensate for the misalignmentto stand on tiptoe is practically impossible. Wise too both the upper and the lower ankle joint marked stiffening and associated Restrictions on movement on. Usually a X-ray of the foot while standing in two levels made in order to best assess the bony structures.

Be therapeutic here too physiotherapy and orthopedic insoles and Shoes (see above), whereby the focus here is clearly on one Correction by orthopedic technology lies. However, it is also important that the To treat the underlying diseasee.g. the adequate treatment of rheumatoid arthritis. In the case of paralysis, for example in the infantile cerebral palsy, epileptic encephalopathy or Meningomyelocele occur, too operational procedures applied.

The focus is on two processes. In the Grice-Green method becomes the lower Ankle joint artificially stiffened so that the buckle foot is canceled. Another method is that after Evants, in which a bone wedge - usually from the Fibula - is inserted into the heel bone to create stability and straighten the foot again. In the latter, the mobility in the ankle is retained.

Stage one of therapy however, consists in any case consultation, physiotherapy and correction using Orthopedic technology. If the x-rays taken for follow-up do not show any improvement, over Stage two in the form of surgical therapy be spoken. In any case, one should first Gait analysis be done to ensure that surgery can restore the gait pattern.

Consequences of the buckling foot

Due to the misalignment of the foot, the entire statics of the body is brought into imbalance. If one or Knee legs such as Knee pain can be the result.
Massive occur as a result of the buckle foot Knee legs, this leg position can affect the entire Spine affect and cause a curvature of the Lumbar spine lead forward. This causes pain in the lower back (see Lower back pain).

Diagnosis

As a rule, buckled foot can be diagnosed simply by looking at the bare foot from behind.
The physiological foot has an approximately 5 degree angle between the heel and lower leg. This angle is significantly increased in patients with a bent foot. In addition, calluses can occur on the inside of the foot due to the increased stress.

The lowering of the ankle head also reveals a double ankle. With the help of a podogram (footprint) the Foot silhouette judge. This makes it easy to assess the inner arch of the foot, which is flattened or completely eliminated in the case of a buckled foot. Further research on how a CT or a X-ray image are only necessary in exceptional cases with severe pain.

therapy

The therapy of the buckle foot depends on its severity. Of the Buckle foot In combination with a flat foot, modern custom-made insoles in the shoes as well as physiotherapy and foot gymnastics can be used in elementary school age.
This is intended to strengthen the foot muscles. Through the Custom insoles should especially the Rear foot and the longitudinal arch are supported.
Walking barefoot also helps strengthen the longitudinal arch. The flat arched feet in toddlers in particular should be treated as early as possible by means of foot gymnastics and walking barefoot.

Then the probability is very high that the misalignment will correct itself in the course of development. If this treatment is not enough, some of the treatments are special Nancy-Hylton or Ring orthoses necessary. In very rare cases, buckles have to be treated surgically. In this way, the muscle pull on the longitudinal arch can be improved, thereby raising the arch of the foot.

Appointment with ?

I would be happy to advise you!

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Treat the articulated foot with insoles

There are different methods one Buckle foot to treat successfully.

One possibility to restore the natural shape of the foot is to use special orthopedic insoles. Insoles, which are used with a buckle foot, stabilize the foot on the so-called inner arch and bring it into the correct position.

There are universal insoles which can be purchased or insoles which can be made individually. Individual insoles take the shape of the affected foot into account and usually help to correct the deformity better.

Particularly with an early diagnosis, it is possible to permanently treat the articulated foot through the use of the insoles. In the case of buckled feet which are only diagnosed in adulthood, the use of insoles can still be useful. These can bring the foot into the correct position and thus effectively prevent secondary damage to the joints.

In any case, it is important to consistently wear the insoles so that the desired effect can be achieved.

OP on a buckled foot

The right therapy for a buckled foot depends on a number of different factors.

In most cases, a buckle foot is already noticed in childhood and does not need to be treated for the time being. In the course of development, the foot usually takes on a normal foot shape.
If a buckle foot persists after the age of 9, therapy should be carried out to prevent sequelae.

In most cases, however, surgical therapy is not necessary.

A buckled foot can usually be treated permanently through various conservative therapy options. Surgical intervention may only be necessary in particularly severe cases so that consequential damage can be prevented and the knee joint can be successfully treated.Surgery is necessary, especially if the buckle foot was only diagnosed in adulthood or if a child's buckle foot does not regress by itself and conservative methods have not been successful in consideration to be pulled.

A frequently performed operation is the implantation of a titanium screw at a specific point on the foot, which can successfully treat an articulated foot by stimulating the muscle structure at the critical point. Whether an operation makes sense in individual cases can best be discussed with the attending physician after a comprehensive diagnosis.

forecast

As a rule, a flat foot has a very good prognosis.

Often they hardly exist even in adulthood Symptoms and complaintsso that therapy is not absolutely necessary either.
With special orthopedic insoles, physiotherapy, Weight reduction and the right footwear can treat any complaints very well. The child's buckle foot also corrects itself in most cases. If the misalignment takes a severe course, it may be necessary for the affected children to wear special orthopedic insoles for up to 3 years. But even in these cases the Foot malposition largely corrected and does not cause discomfort.

Buckle foot in children

If an articulated foot that is diagnosed in an adult is always a disease that requires therapy, this is not necessarily the case in a child's articulated foot. Children with buckled feet usually change the shape of their feet again during the growth phase and should not have buckled feet until they are 9 years old. Only when the buckle foot is still there after the age of 9 If you are present, we recommend a visit to an orthopedic surgeon for further clarification.

The causes for the occurrence of a buckle foot in children and toddlers are mostly genetic.

This results from the fact that the buckling of the feet makes learning to walk much easier.
Since the child's ligamentous apparatus is much weaker than that of adults, the buckling of the foot helps with the stability of the child when standing and walking. However, the child's foot position should change over time. If the knee joint appears after learning to walk and is thus acquired, there may be a serious reason behind the change.
Especially:

Accidents
wrong footwear, and in rare cases that
Presence of infectious diseases

can cause a change in the shape of the foot.

The consequences of a buckled foot which also after the 9th year of life still present can be serious. The higher stress on the joints leads to early signs of wear and tear and thus often to osteoarthritis of the joints. The knee joint and ankle in particular are often affected by consequential damage from an untreated knee joint.

In order to prevent sequelae, parents should pay attention to whether their child's buckle foot is still present after the age of 9 or whether it has receded.
If there is still a buckled foot after this time, it is necessary to carry out therapy as soon as possible.

As a rule, a buckle foot in children can be treated well with the help of conservative measures. In particular, the use of special insoles and physiotherapy can help treat the child's buckled foot. Weight reduction is an urgent priority in overweight children. Should conservative measures not lead to success, an operative measure can be considered in individual cases.

Summary

The buckled foot is a misalignment of the foot that, if left untreated and severely developed, can lead to malpositions of the entire leg.
Up to the age of 8 to 10 this form is the Foot malposition however completely normal and does not require any treatment.
However, if after the age of 10 the foot has not stabilized enough for the position of the foot to normalize, therapy is advisable. This consists of physiotherapy to strengthen the foot muscles. In addition, those affected should wear special insoles in their shoes, which strengthen the longitudinal arch and the rear foot.

Surgical therapies are usually not necessary. The diagnosis of the buckle foot is very easy, since the foot malposition can be recognized by simply looking at the standing bare foot. Thanks to efficient conservative therapy, buckles have a very good prognosis and generally do not lead to permanent impairment of walking or pain while running.