High arched feet

Introduction to Gao Gongzu High arch foot is a common foot deformity, mostly caused by neuromuscular disease, the forefoot fixed plantar flexion, which increases the longitudinal arch. Sometimes combined with varus deformity. Occasionally, the cause is unknown, it can be called idiopathic high arch foot. Common types include high-bow toe-foot, high-bow-footed feet, high-bow inversion feet, high-turning feet, and high-heeled bows. The high-bow toe and high-heeled foot are mainly due to the gastrocnemius and the soleus tendon, while the part of the foot has a strong extensor muscle, and the decidual contracture often coexists; the high-bow-shaped foot is the internal muscle of the foot or One or more groups of muscles in the external muscles are caused by imbalance of muscle strength, and the squamous membrane contracture; if the internal and external muscle strength of the foot is unbalanced, it is often accompanied by internal and external varus deformities. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: dislocation of the ankle joint ankle sprain

High arch foot cause

Neuromuscular lesions (80%)

The cause of the disease is very complicated, and about 80% of the cases are neuromuscular diseases, which cause the reduction of the dynamic factors of the arch, such as the weakening of the tibialis anterior or/or calf triceps muscles, and the intrinsic muscle contracture of the ankle and foot. Causes the increase of the longitudinal arch. These neuromuscular diseases can occur in different levels of the brain cone system, spinal cord cortex, spinal anterior horn cells, peripheral nerves and muscles. Common diseases include myelitis, cerebral palsy, and cerebral spinal ridge. Membrane bulging, neural tube insufficiency, and other diseases are relatively rare, such as spinal cord longitudinal fissure, tethered cord syndrome, Charcot-Marie-Tooth disease.

Congenital factors (10%)

In some cases, there is a clear family history, and the disease that occurs when a patient is born is related to the mother's exposure to environmental harmful factors during pregnancy. Such as pesticides, organic solvents, heavy metals and other chemicals, or excessive exposure to various rays, or take certain drugs, or infected with certain bacteria. Because there is no evidence of neuromuscular disease, it may be congenital lesions.

High arch prevention

The etiology of this disease is complicated, so it is extremely difficult to prevent. Therefore, the diagnosis of this disease should pay attention to find out its cause, and whether the identification is secondary or primary, in order to take correct treatment for this disease, in children. After some neuromuscular diseases occur, it should be actively checked to prevent the occurrence of this disease.

High arch and foot complications Complications, ankle dislocation, ankle sprain

Regardless of the cause of the primary disease, the formation of high arch deformity, the original change is mainly due to the atrophy of the inner muscles of the foot, the head of the humerus sinks due to the loss of the back muscles, and the front arm of the longitudinal arch is lowered. In addition, the aponeurosis gradually collapses, forming a tough bowstring, the top of the bow is gradually increasing, and the degree of the high arch is higher. The composition of the forearm of the longitudinal arch is mainly based on the first metatarsal, so the degree of change of the first metatarsal can determine the high bow. Degree, after the humeral head sinks, the compensatory tension of the toe long extensor tendon in the base of the phalanx at the end of the last section is increased. For a long time, the metatarsophalangeal joint is excessively stretched and even semi-dislocated, so the high arch is accompanied by the claw toe and toe. After stretching, when standing and walking, it can't touch the ground. When the walking stage is in the early stage, it loses its propulsive force between the ground and the ground. Because the first humeral head is forced to rotate in order to replace this, the pronation is gradually formed.

High arched foot symptoms Common symptoms Horseshoe varus foot horseshoe valgus foot can not bend and varus foot ulcers 1st toe joint pain... Foot deformity striate middle hallux ball area... Claw-like foot Invert

Depending on the degree of arch height increase, whether it is accompanied by other deformities of the foot, the high arch foot is usually divided into four types.

1, simple high arch foot:

Mainly the forefoot has a fixed plantar flexion deformity, the first and fifth metatarsal are evenly weighted, the medial and lateral medial arches are consistently increased, the heel remains neutral, or there is mild eversion.

2. Inverted high arch foot:

This type only has the medial column of the forefoot, which is the first, the deformity of the plantar flexion of the second metatarsal, which increases the internal longitudinal arch, while the outer longitudinal arch is still normal. When the weight is not heavy, the fifth metatarsal is easily raised to the neutral position, and the first Because of the fixed plantar flexion, the tibia can not passively extend back to the neutral position, and has a 20~30° internal rotation deformity. The initial hind foot is more normal. When standing and walking, the pressure on the first metatarsal head is significantly increased. To relieve the pressure of the first metatarsal head, patients often take the weight of the foot varus posture, and the posterior foot has a fixed varus deformity. The patient has a claw-shaped toe, the first metatarsal head protrudes to the sole of the foot, and the soft tissue thickens in the weight-bearing area of the foot. , carcass formation and pain.

3, with the line type high bow foot:

Common in poliomyelitis, spinal cord bulging, mainly caused by paralysis of the triceps of the calf, characterized by the calcaneus in the state of extension, the forefoot is fixed in the plantar flexion.

4, the flexion type high arch foot:

After secondary congenital clubfoot surgery, this type has a fixed plantar flexion deformity in the forefoot. The posterior foot and ankle joint also have obvious plantar flexion deformity. The clinical manifestations of each type of high arch foot are not consistent. However, the forefoot has a fixed plantar flexion deformity, and the toe is more normal in the early stage. As the disease progresses, the toe is gradually retracted, the toe joint is flexed, and the metatarsophalangeal joint is excessively stretched, showing a claw toe deformity. Severe toe can not touch the ground, due to the metatarsal deformity of the metatarsophalangeal joint, the subtotal dislocation of the metatarsophalangeal joint, so that the proximal phalangeal base is pressed against the dorsal side of the humeral head, which will aggravate the plantar flexion deformity of the humerus, resulting in thickening of the skin at the weight. The carcass is formed, and even ulcers are formed.

High arch examination

The auxiliary examination method for this disease is mainly X-ray examination:

X-ray examination should take the X-ray of the lateral position of the foot under weight-bearing conditions. The normal foot is far from the first wedge, and the proximal joint surface is parallel to each other. The high-footed foot has a plantar flexion deformity, which occurs mostly in the first The wedge joint makes the equal line of the distal and proximal articular surface converge on the temporal side. M'eary measures the angle between the central axis of the talus and the central axis of the first humerus. When the arch is normal, the two lines are continuous. If the angle can be measured, Indicates that the arch is increased.

Hibbs measures the angle formed by the central axis of the calcaneus and the central axis of the first metatarsal. The normal value is 150-175°, while the angle of the high arch deformity is reduced. In addition, the positive position measures the heel angle, if <20° It indicates that there is a deformed hind foot deformity.

High arch foot diagnosis

According to the gait abnormality of the child, the longitudinal arch height is increased with the claw-toe deformity, and the M'eary angle is increased by X-ray examination. The Hibbs angle is reduced, and the diagnosis of high arch foot can be made. However, the high arch foot multi-line nerve Malformations caused by muscle diseases should be further examined to find the primary disease or potential pathogenic factors, and the cause of the disease should be identified. At this time, EMG, CT or MRI of the skull or spinal cord can be performed to determine the cause of the disease. Prognosis is of great significance.

1. The general simple pointed foot (simple clubfoot) caused by the shortening of the Achilles tendon, the arch of the foot is not high, the heel can not touch the ground when walking, and the calcaneus and the humeral head can step on the ground when the high arch is sufficient;

2, the high arch of the sequelae of kenaf is caused by the inability of the Achilles tendon to sag, or the lack of anterior extension of the foot, which is caused by a disease, non-progressive aggravation;

3, congenital clubfoot is born after birth, with tight and small calcaneus, anterior inversion of the foot and lateral iliac crest;

4, the deformity of the foot caused by meningocele can be aggravated with age, the deformity is varus foot tip, more than the sensory disturbance of the foot skin, the lateral ulcer or the nutritional ulcer of the ankle.

The above diseases should be carefully examined to make a difference.

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