What is the cause of functional flatfoot? Can it be treated? Child 1 1 year

Flat foot refers to foot pain caused by flat arch and loss of elasticity. Flat feet are also called flat feet and flat feet, including congenital flat feet and acquired flat feet. Congenital cause 1. The abnormal bones of the foot are mainly due to the oversized scaphoid and the oversized scaphoid tubercle, which leads to the weakness of the attachment of the posterior tibial muscle. 2. The first metatarsal is short, and as a result, the other metatarsals bear too much gravity, resulting in a flat arch. 3. Cartilage or fiber of foot bone. Acquired reasons 1, standing with heavy feet for a long time, gaining weight, and fatigue after a long journey will all cause the muscles, ligaments, joint capsules, aponeurosis and other soft tissues that maintain the arch of the foot to gradually weaken, and the arch of the hind foot will gradually become lower and flatter. 2. Patients who have been ill in bed for a long time, due to lack of exercise, cause muscle atrophy and weakened tension, and once they are loaded, their arches will sink. 3. Inappropriate shoes, such as high heels, will move the center of gravity forward for a long time, and the corresponding calcaneus will tilt back and forth, causing damage to the longitudinal arch of the foot and forming flat feet. 4, foot bone diseases, such as rheumatoid arthritis, bone and joint tuberculosis. It can also lead to foot bone deformation and flat arch. 5, polio sequelae lead to flat feet. Etiological pathological foot is the structure of human body bearing, walking and damping. For walking and shock absorption, the foot forms two longitudinal arches and one transverse arch, which is maintained by the bones, ligaments and muscles of the foot. Fatigue or chronic strain can cause acquired flatfoot, and most of the patients are immature teenagers. If standing for a long time and carrying too much weight, it can cause strain of the ligament of the foot, atrophy of the medial and lateral muscles of the foot, and then lower the medial longitudinal arch (Figure 6-2 1). The common strain is medial ligament and calcaneal ligament, which can be stretched after excessive traction, which widens the distance between the calcaneal load-bearing process and the scaphoid of the foot, resulting in a smaller distance from the bone and a bulge of the inner edge of the foot. Because it changes the normal structure of the foot, it will cause symptoms such as foot pain. In addition, abnormal healing of foot fractures (such as calcaneus and tarsus), paralysis of anterior and posterior tibialis muscles, and high heels can all cause flatfoot. Key points of diagnosis: Some patients may have no pain or discomfort at the beginning, but most patients often feel foot pain and fatigue, which is obvious when carrying weight and relieved after rest. If the disease develops, the arch of the foot will collapse. When examining the affected foot, it can be found that the longitudinal arch of the foot is low and the heel is everted. Forefoot abduction, scaphoid tubercle protruding inward with tenderness, calluses on the first metatarsal and the inner edge of heel, and the inner heel of the patient is worn. When printing the sole with gypsum powder, you can see that the sole completely touches the ground (Figure 6-22). If the course of the disease is long, the foot will be stiffer than the abduction. Even in the eversion position, the bones and joints also undergo adaptive changes, and it is almost impossible to make passive varus movements. Treatment 1. Meridian massage mainly restores the normal position of talocalcaneal joint, and the flat foot with obvious deformity can be corrected by manipulation. In supine position, the patient should massage the ankle and gently shake the ankle in front of the ankle and calf, then the operator holds the heel with his left hand and the front of the foot with his right hand. In order to facilitate exertion, the heel of the affected side can be pressed against the thigh of the operator as a fulcrum, and the foot of the affected side will be turned inward as much as possible. When the foot is varus, a slight soft tissue tearing sound can be heard, and there is pain locally. At this point, the performer still needs to hold the heel and the front of the foot with both hands and try to keep varus. At the same time, the affected foot was fixed in varus position with cardboard bandage or plaster. Because of long-term deformity, the affected foot still has the tendency of eversion, so patients can be taught to evert their feet often with their bare hands. Manual correction can be performed again 3 days after operation. During the treatment, it is forbidden to walk with the affected foot. If the deformity improves after 3 weeks, you can wear orthopedic shoes and gradually resume walking. Light and flat feet do not need manual treatment, and it is necessary to avoid overloading or standing for too long. Those with mild symptoms can use flat-footed insoles to help maintain a normal arch. Those with severe symptoms can wear orthopedic shoes with flat feet for a long time, and orthopedic shoes has built-in insole with flat feet. Proper orthopedic shoes can make the calcaneus slightly varus and make the load-bearing line of the foot more normal. 2. Drug therapy can take Jianbu Qian Hu Pill and other drugs for strengthening bones and muscles for a long time. Patients with sores are locally fumigated with erythrinus bark soup or Baxian Xiaoyao soup. 3. If the pain can't be relieved by surgical treatment, and it affects moderate and severe flat feet when walking with weight and wearing shoes, the patient's age is >; 10 years old is the indication of surgical treatment. Surgical treatment includes soft tissue surgery such as tendon transfer and ligament contraction, as well as bone surgery such as tarsal joint fusion, three-joint fixation and tarsal osteotomy. However, simple soft tissue surgery and single tarsal joint fusion have been abandoned because of poor curative effect. At present, it tends to combine soft tissue and bone surgery, and the curative effect is obviously improved. Usually, according to X-ray measurement, after determining the descending position of the longitudinal arch of the foot, the surgical method is selected. Pay special attention to the problem of shoes Most flat feet are caused by improper shoes. Don't wear any shoes with heels, which will increase the arch pressure and aggravate flat feet. Flat shoes must be better than shoes with heels. Wearing flat shoes has stronger walking ability and lighter symptoms than wearing shoes with heels. Patients with flatfoot often walk on the heel and lateral foot, which can reduce the arch pressure and relieve symptoms. Try it: barefoot or wearing flat shoes, step on a book about 18 mm thick with your front foot and step on the ground with your heel to see if the symptoms of flat feet are alleviated. If there is any relief, you can use negative heel shoes with high front and low back. The sole is high in the front and low in the back, which can effectively reduce the pressure on the forefoot and arch. It is an effective forefoot and arch decompression shoe. This change of plantar stress can reduce the burden of ligaments, which is beneficial to the walking and pain relief of patients with flat feet. But also beneficial to health. Negative heel shoes can be bought in some top three hospitals. High heels of any height will increase the pressure on the arch-high heels are highly harmful, while middle heels are moderately harmful, not beneficial! The basic knowledge of flat foot correction is wrong. "Arch" is not "arch". Let's first understand the structure of the arch. It consists of upper and lower parts, which can be vividly compared to the structure of bows and arrows. The upper part is like the back of a bow, and the lower part is like a bowstring. The bowstring of the arch of the foot is plantar aponeurosis, which starts from calcaneal tubercle, divides into five tendons forward, and ends at flexor tendon sheath and transverse metatarsal ligament, and is the bowstring that maintains the longitudinal arch of the foot. Plantar aponeurosis is an important structure to maintain the arch of the foot. If you relax this arch string, the height of the arch will inevitably decrease. The function of the arch pad is to support the arch back of the arch, but before supporting the arch back, it has already played a very unfavorable role in the plantar aponeurosis. This hard pad is installed under the arch of the foot. When people stand and walk, the plantar aponeurosis is constantly squeezed and pulled, so that the plantar aponeurosis is stretched and relaxed. When people put on shoes to correct their arches, they will feel pain in the soles of their feet, that is, the hard arch pad is stretching the plantar aponeurosis. If people wear hard orthopedic insoles for a long time, the consequences will be unimaginable. The injury of "bowstring" is the injury of arch. Although many people spend a lot of money on arch correction shoes, they just don't want to wear them, or even if they wear them, they rarely stand and walk because their feet are very distressed. The biggest problem in the design of arch pad is that it ignores the function of plantar aponeurosis as a "bowstring", which is very important. The arch of the foot is a whole composed of "arch back" and "bow string", so it is against the physiological and mechanical structure of the foot to emphasize the support of "arch back" mechanically. At present, many insoles for correcting flat feet are harmful and useless, and this is the problem. As long as you feel unbearable pain in your feet, it means that the plantar aponeurosis has been unreasonably pulled, which can only lead to the further development of flat feet and the pain will become more and more serious. Middle-heeled shoes will aggravate flat feet, so patients should treat them rationally to avoid unnecessary injuries. Nowadays, all flat-footed corrective shoes have heels, and it is also a mistake in principle to think that it is necessary to correct them. As a professional research institution, we are very responsible to tell you that there is no scientific basis and it is pseudoscience. Everyone knows that high-heeled shoes are harmful to the health of feet, and the role of middle-heeled shoes is the same, but to a lesser extent. The core theory of middle-heeled shoes is that middle-heeled shoes can make the sole stress uniform, but uniformity does not mean rationality. Let's look at the picture. The arch of foot is not a uniform and symmetrical structure. The rear part is much stronger than the front part in muscles, bones and ligaments, so it is reasonable to let the rear part of the foot bear more gravity, but it is unreasonable to let the front and rear parts bear the same gravity. There is no reason to increase the pressure on the front foot. No matter from that point of view, it is a low-level mistake of pure amateurs and a logical mistake, and there can be no scientific basis. But what is incredible is that this kind of low-level mistake of pure amateurs has been publicized as scientific common sense, which is harmful to people. For patients with flat feet, shoes with heels are not suitable. Heels of any height will increase the stress in the front of the weak arch, resulting in a decrease in the height of the arch. The medical profession recognizes that barefoot is good for health, and the mechanical state of flat shoes and barefoot is basically the same. Then, from the perspective of pure health, shoes should not have heels, even flat-footed corrective shoes for foot diseases should not have heels, and so should sports shoes. The key shaping training shoes for arch decompression and flat foot rehabilitation are negative heel shoes with high front and low back, so that the stress on the heel is the greatest, and the stress on the arch is greatly reduced, which is conducive to maintaining the arch height. Flat feet are caused by excessive stress on the arch, so it is necessary to reduce the pressure on the arch in the rehabilitation of flat feet, which is a prerequisite and necessary. If the arch pressure is not reduced, no effort can be effective. Functional exercise of muscles related to the arch of the foot Wear shoes with high front and low front, and you can fully exercise tibialis anterior, posterior tibial muscle, peroneal longus muscle and gastrocnemius muscle during walking. The strength of these muscle tissues is conducive to the maintenance and promotion of the arch of the foot. Avoiding achilles tendon contracture also has a great influence on flat feet. The tighter the achilles tendon, the greater the tensile force on the plantar aponeurosis. Shoes with high front and high rear soles can stretch the achilles tendon, effectively avoid contracture of the achilles tendon, prevent spasmodic flat feet and protect the arch of the foot. Interviewee: No.1 heroine LL | Level 1 | 201-5-2113: 36.