What is a hollow foot? You can find a photo of this pathology in the presented article. We will also define the disease in question, identify the causes of its occurrence, list the symptoms and talk about the treatment.
Basic information
What is a hollow foot? This is a pathology that implies deformation of the lower extremities. It is characterized by lowering the tips of the fingers down and raising the heel up. As a result of such a deformation, the size of the arched vault noticeably 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 flatfoot.
Stages of deformation
What does the treatment of the hollow foot depend on? Experts say that the choice of a particular therapy is directly related to the stage at which the disease is located. Specialists distinguish 2 stages of deformation:
- At the very beginning of the disease, there is a change in soft tissues (morphological). To eliminate this problem, doctors recommend that the patient apply pressure on the head of the first metatarsalbones.
- If measures to treat the developed deformity were not 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 the increase in the arched vault have not yet been elucidated. However, doctors suggest that such a pathology may occur due to imbalance (muscular) against the background of hypertonicity or 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 noticeable decrease or, conversely, an increase in the tone of muscle tissues.
According to the opinion of most doctors, most often the hollow foot is formed due to the pathology of the neuromuscular apparatus and a number of diseases, as well as muscular dystrophy, poliomyelitis, 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 provoked the hollow foot remain unexplained.
Symptoms of disease
In pharmacies and medical centers, insoles for the hollow foot are very often sold. What are they needed for? The point is that this disease is notpasses without a trace for the patient.
With an increase in the arched arch, the patient constantly complains of pain in the feet, fatigue while walking and discomfort in the ankle joints. Also, some patients report that they have great difficulty in choosing comfortable shoes.
When examining a person with the pathology under consideration, specialists reveal an increase in the height of the internal and external arch, flattening, expansion and slight adduction of the anterior soles, painful calluses (for example, at the base of the first toe and in the little finger area), as well as deformity of the fingers. In addition, such a patient quite often has severe stiffness of the foot.
Other signs
A hollow foot due to poliomyelitis may be accompanied by mild unilateral paresis in combination with foot equinus. At the same time, the tone of muscle tissues is reduced, and the deformation does not progress.
If a person has cerebral lesions, then he may experience spastic phenomena, increased muscle tone and increased reflexes (tendon). Such a process is not progressive and one-sided.
In congenital malformations, the pathology is usually bilateral. It tends to progress, especially during periods of active growth (for example, at 5-8 years and at 11-15).
With the 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.
Elevation of the arch of the foot is quite often combined with ataxia and gait disorders. In addition, this disease is characterized by mild sensory disorders and lesions of the pyramidal tract.
In Charcot-Marie-Tooth disease, a person has 2-sided and progressive deformity of the feet, as well as muscle atrophy, which spreads from bottom to top.
How is it diagnosed?
Exercises with a hollow foot should be performed without fail. However, this should be done only after the diagnosis is 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 deformity, the plantogram shows a large depression of the concave arc of the inner edge, as well as a protrusion along the outer edge of the foot. With moderate pathology, concavity is observed up 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 advanced 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 performs a detailed neurological examination, performs X-rays of the spine, MRI and CT scans, as well as electromyography and other studies.
An old tarsal injury may require a foot CT scan.
If the hollow foot was detected for the first time and at the same timethe patient has no diseases of the neuromuscular system, and there are no previous injuries, this indicates the possible occurrence of a tumor of the spinal cord. In this case, the person is referred to an oncologist for examination.
How to treat?
The tactics of treating the cavus foot 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 mild pathologies, the patient is prescribed physiotherapy exercises, physiotherapy and massage. Non-fixed forms of this disease are amenable to conservative correction by wearing special shoes with a raised inner edge.
Strong fixed disease, especially in adults, subject to surgical treatment.
Depending on the type of pathology and the causes of its development, arthrodesis, osteotomy, crescent or wedge resection of the tarsal bones, tendon grafting and dissection of the plantar fascia can be performed. Various combinations of these techniques are also used.
Surgery
The operation to restore the foot is carried out in a planned manner under conduction anesthesia. The best option is a combined surgical intervention according to Chaklin or Kuslik. The latter method involves open dissection or redressing of the plantar aponeurosis in conjunction with falciform or wedge resection of the cuboid bone. As soon as the resected area is removed, the back sections of the feet are bent towards the sole, and the front - towards the rear. After thatthe wound is sutured, drained, and a cast is applied to the lower limb, which is not removed for 6-7 weeks.
In the operation according to the Chaklin method, the plantar aponeurosis is also redressed or dissected. Next, the bones of the tarsus are exposed. In this case, the extensor tendons are retracted to the sides, and then a wedge-shaped resection of a part of the cuboid bone and the head of the talus is performed.
As for the navicular bone, it is removed partially or completely, depending on the severity of the deformity.
In case of strong prolapse of the first metatarsal bone, its (additionally) osteotomy is carried out. When observing the equinus, an Achilles tendon tenotomy is performed.
In the event that during the surgical intervention the position of the foot could not be corrected, a cast is applied to the leg for 3 weeks, after which it is removed and the final correction is made. Then the bandage is applied again for another 4 weeks.
Insoles and exercises
Can a hollow foot be treated? Insoles and properly fitting shoes are one of the easiest ways to get rid of foot deformity, as well as its prevention.
According to experts, with a hollow foot, patients should give their preference to shoes with a wide platform and low heels. This will help keep the leg in the correct position.
It should also be noted that buying orthopedic shoes should only be under the supervision of a doctor. By the way, the latter can recommend shoes with a raised inner edge. To provide proper supportarches 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 sitting. The exercise is performed freely, 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 size should be gradually reduced, and their weight should be increased.
- Starting position standing. Toes in, heels out, maximum external rotation of the shins, then transition to the outer edge of the foot. Next - lowering to the surface of the soles.
Also, to eliminate discomfort, the patient is prescribed paraffin baths, warm baths and manual correction of deformity in the form of a massage.
