Buckle foot

At the Buckle foot it is a congenital or acquired misalignment of the foot. The affected foot descends on the medial inner edge of the foot and rises on the lateral outer edge. Foot exercises are usually used to correct this.

What is a buckle foot?

Misalignments of the foot can be congenital and acquired, for example flat feet. Other foot deformities can develop from these misalignments over time. One of them is the so-called Buckle foot. This is a misalignment in which the medial inner edge of the foot lowers while the laterally outer edge rises.

In the toddler, this image is considered to be the physiological stage of development and is therefore not associated with disease value. Adults with bent feet can, but need not, suffer from the deformity. A buckled foot, for example, can develop bow legs or knock knees. Other complications and pain are also conceivable. Basically every type of buckle foot affects the statics of the body.

Nevertheless, the malalignment does not necessarily have to be treated if the patient decides against the therapeutic intervention despite being aware of the possible consequences. The buckle foot or pes valgus is not only common among humans but also in the animal kingdom. Large dog breeds, for example, often suffer from the phenomenon. Usually a growth disorder of the lower fibula-epiphyseal plate is responsible for this. The buckle foot can be associated with a flat or flat foot.

causes

Between eight and ten years of age, a child's foot becomes firm enough that the foot hardly bends inward. If this is not the case, there is a pathological arched foot. Knuckle feet can not only be acquired in the course of life, they can also be congenital. Acquired buckles usually develop from a congenital or acquired flat foot, after trauma to the foot bones, spastic paresis of the foot or as a result of an infection.

Rheumatism, overuse damage with ligament instability or obesity can also contribute to the development of a knee joint. The head of the talus is pressed down with the buckle foot and shifts medially so that the calcaneus is in the pronation position. The image of a double ankle is created because the talus clearly protrudes below the ankle.

Due to the changed position of the ankle bone in the ankle fork, the foot is positioned diagonally against the lower leg, with the inner edge of the foot lowering. Apart from this developmental process, the arched foot can be the symptom of a congenital malposition or even malformation syndrome.

Symptoms, ailments & signs

Subjectively, patients with arched feet often have no complaints. Pain is rather rare and occurs mainly in the area of ​​the inner ankle or the inner longitudinal arch, if at all. This is especially true for patients who suffer from a buckled foot and a sagging foot at the same time.

In later stages, the ankle pain can stretch along the side of the leg and radiate to the hip. Since the inner ankle protrudes strongly in the arched foot, the lower ankle joint shifts and the calcaneus deviates outwards. Only in extremely rare cases do pronounced buckles cause pain in the outer ankle due to a collision with the calcaneus.

The statics of the body is always impaired by a bent foot. In most cases, however, patients with a congenital arched foot are not even aware of this impairment. Only when knee problems, bow or knock knees arise from the buckle foot, do many people concerned seek medical advice.

Diagnosis & course of disease

The doctor looks at the barefoot patient to diagnose the buckled foot. From behind, the patient in this position shows an approximately five-degree angle between the lower leg axis and heel. With a buckle foot, this angle is significantly increased. The varus position of the heel is often reduced when standing on the toes.

The sole of the foot may show callous growth on the medial heel. The diagnosis can be confirmed by means of imaging procedures. The x-ray shows an increased eversion in the area of ​​the subtalar joint. Even without such an eversion being detectable, however, there may be a buckled foot, so that the x-ray is often not required.

Complications

A buckled foot does not always have to result in particular complaints, restrictions or complications. In many cases, people with a knee joint can lead an ordinary life. Furthermore, pain in the ankles can develop and spread to other regions of the leg or even to the hip.

The articulated foot can also restrict the patient's movement. The patient's sense of balance and coordination are also significantly impaired by this disease. If the buckle foot occurs in childhood, it can still lead to crossed legs in adulthood. Many patients also suffer from aesthetic complaints.

Especially with children, the knee joint can lead to teasing or bullying. In this case, treatment only needs to be given if the person concerned is suffering from symptoms. Various therapies or interventions can correct the misalignment. Psychological treatment may also be necessary. The articulated foot does not usually reduce life expectancy.

When should you go to the doctor?

A bent foot does not always have to be treated by a doctor. Often times, patients with buckle foot can lead a normal life without experiencing pain or other problems. A doctor's visit is necessary if the buckle foot causes symptoms. Pain, misalignment or signs of joint wear must be clarified and treated by a doctor. Medical advice is also required if the buckle foot significantly affects the quality of life.

You should also see a doctor regularly if you have a broken foot with a serious illness. Rheumatism and obesity patients have to keep in close consultation with the responsible doctor. If the ankle pain worsens and radiates to the leg or even to the hip, medical advice is necessary. Knee problems, bowlegs or knock knees as well as joint problems are further reasons to go to a doctor with the knee joint. The family doctor can put you in touch with an orthopedic surgeon or rheumatologist. In the event of severe complaints, the emergency medical service or the nearest hospital should be contacted quickly.

Treatment & Therapy

In most cases, bent feet do not require any further therapy. This is especially true if the patient does not notice any complaints subjectively. However, if pain, knee discomfort or even bow or knock knees become apparent, further development can be countered with treatment. As a rule, insoles are sufficient as a treatment measure. Only in extremely rare cases does an operation take place.

This applies, for example, when the tibialis posterior muscle and its tendon are unstable. In this case, a tendon transfer can be arranged in combination with a heel bone osteotomy. The invasive treatment must be carefully assessed in advance by the doctor in terms of its benefits and risks for the patient. If the risks outweigh the benefits, then foot exercises are more likely to be prescribed than surgery.

In the gymnastic sessions at least an improvement in the symptoms can usually be achieved, as the muscles and tendons become more stable through the movement. If the knee is already misaligned, a high tibial head osteotomy or a supracondylar femoral osteotomy may be performed to correct it. If the misalignment has affected the spine, attending a back school is advisable.

Outlook & forecast

Most patients have a favorable prognosis. Often there are no other complaints, so that the visual change has no disease value from a medical point of view. Therefore, no treatment is taken in these cases. The quality of life is not impaired any further and the duration of life is also not shortened by the disorder.

If there are physical impairments, individual treatment steps are initiated. A treatment plan is drawn up depending on the extent of the symptoms. This can use conservative methods or provide for a surgical procedure. The aim is to improve the opportunities for movement. Normally, the desired optimizations are achieved if the patient adheres to the specifications and no further complications occur. Nevertheless, when making a prognosis, it must be taken into account that every operation is associated with risks and side effects.

In rare cases, due to the optical changes, emotional and psychological stress conditions also occur. Although there are no physical complaints from the buckle foot, the stress can have a negative effect on the overall condition of the patient. There is a risk that psychological complications will develop and manifest themselves. These lead to a worsening of the prognosis, as they are usually protracted and have a strong negative influence on the well-being of the person concerned. It can lead to anxiety disorders or attachment problems, which lead to impaired lifestyle.

prevention

If a toddler still has a deformed foot at the age of seven, a permanent knee joint can be prevented with measures such as foot gymnastics. In addition, walking barefoot on uneven floors can stabilize the unstable foot.

Aftercare

Children and adolescents who are affected by a foot deformity - such as the knee joint - should be permanently looked after by a specialist. This can document the course and provide a prognosis for further development. This is urgently needed, especially during the growth phase.

The specialist, in most cases an orthopedic surgeon, will also decide whether a surgical procedure is necessary and provide ongoing medical care for those affected. If an operation has been performed on the foot, it is advisable to continue to have an orthopedic check-up once a year. In addition, it is usually necessary to wear orthopedic shoe adjustments or insoles.

Sometimes it is necessary to make a custom shoe. Their fit can also be confirmed by a specialist. This can also give advice when choosing a specialist shop. Physiotherapy and the application of ointments can also be prescribed. In physiotherapy, foot exercises are taught, which the patient should also do regularly at home.

Due to the improved, now minimally invasive surgical methods, the follow-up periods have been shortened significantly. As a rule, walking without a support is possible after eight weeks. Any symptoms of paralysis or other sensory disorders that occur in the patient vary. The intensity of this lengthens or shortens the duration of the follow-up and decides on the selected support methods. Those affected should only start exercising again after at least four months.

You can do that yourself

In many cases, a flat foot does not need treatment. Treatment is only necessary if the patient is in pain or other complaints. Medical therapy can be supported by the patient by protecting the affected foot. In addition, the doctor's instructions should be observed.

It is usually sufficient to wear the prescribed insoles and otherwise not to put any further strain on the foot. Regular checks by the doctor are also advisable. This will ensure that the buckle foot does not strengthen and that complications do not arise.

If an operation is necessary, further self-help measures should be avoided. It is advisable to follow medical advice and not to unnecessarily strain the foot or the tendons. After surgery, the surgical wound must be carefully cared for to avoid bleeding, infection and other post-operative complications. Should there be any complaints, a doctor should be consulted. In the event of acute pain, problems with movement or symptoms of paralysis, it is best to speak to the doctor responsible immediately. After the treatment, in consultation with the doctor, light stretching exercises and sporting measures can be started to support the healing process.