The structure of the human foot and diseases

It is obvious that neglecting such a complex increases the risk of diseases and disorders of the foot, which often take on a severe form and cannot be treated with conventional conservative measures.

Taylorian deformity

Taylor's deformity is a deformity of the foot in which the last metatarsal and the little toe are out of position. This causes a bony protrusion on the outside of the foot that can be very painful. The condition got its name centuries ago because it afflicted tailors who spent long hours sitting cross-legged, leaning on the outside edge of the foot.

The condition is still widespread today and affects women more often, but men of all ages can also suffer from it.

The doctors at the ON CLINIC have extensive experience in the treatment of joint diseases, undergo regular further training and exchange their experiences with colleagues at scientific and further training events. Our specialists are ready to help even in difficult and neglected situations! We look forward to welcoming you to our clinics!

What is Taylor's Deformity?

The habit of sitting cross-legged for a long time leads to constant stress on the outer surfaces of the feet. The nutrition of these areas is compromised and micro-injuries occur in the bones and cartilage. The last metatarsal deforms (its axis deviates towards the outside of the foot), resulting in a curvature of the little toe towards the ring toe and the typical clubfoot bulge.

The foot begins to widen, which can make it difficult not only to exercise, but even to walk slowly.

Other causes of the Taylor deformity include:

• Congenital or inherited peculiarities in the structure of the foot and a predisposition to certain disorders;
• Changes in the structure of the fifth toe, the foot itself (flatfoot, clubfoot);
• Prolonged wearing of unsuitable, tight, uncomfortable shoes with high heels or platforms;
• Trauma, fractures, abnormally healed bones of the little toe;
• tumors;
• certain neurological disorders.

The non-physiological structure of the little toe can be congenital or acquired. This disorder is often combined with a deformity of the big toe, which makes the foot even wider. The reason for this is a weakening of the interdigital ligaments of the foot.

If left untreated, it leads to an unsteady foot hold, the little toe loses mobility and the constant pain makes life difficult, can lead to purulent inflammation and cause nerve damage.

pain in the foot

The foot has a complex structure made up of more than 15 bones and 10 joints. Thanks to this structure, the human body gains stability in movement. Every day the foot is exposed to stress, absorbs shock when walking and running and helps to push off and maintain balance. It is therefore not surprising that foot pain sometimes occurs. In medical practice, complaints about this are quite common.

The information in this section should not be used for self-diagnosis and self-treatment. In the event of pain or other aggravation of the condition, diagnostic tests should only be ordered by the attending physician. You should see a specialist to diagnose the problem and prescribe appropriate treatment.

place of pain.

The symptoms can occur in a specific area or affect the entire foot. The location of the pain depends on the underlying cause. Foot problems can be concentrated in a specific area of the foot:

There are many causes of foot problems. Each requires a different treatment approach. Determining the cause of foot pain is the job of a specialist. The following pathologies are the source of the symptom:

• inflammatory processes in the ankles;
• damage to nerves;
• fracture, dislocation, fracture;
• heel spur;
• flat feet;
• Arthritis;
• plantar fasciitis.

Uncomfortable shoes can be a source of foot pain. High-heeled shoes, narrow toes, and platform shoes cause discomfort in the foot. And if you are overweight, the risk of severe foot pain is greatly increased. In addition, foot pain is also caused by minor skin imperfections such as calluses, corns, warts or ingrown nails.

Prolonged bed rest and lack of exercise also have a negative effect on the condition of the feet. Many patients experience depletion of bones and muscle tendons, resulting in unbearable discomfort. All of the above factors cause foot pain to some extent, but the true causes can only be determined after a series of investigations.

diagnosis

Foot pain can also be caused by minor skin problems such as calluses, corns, warts, or ingrown nails. Such problems are easily diagnosed at home. An online self-diagnosis service can help with this. It is freely accessible on the Internet. However, self-diagnosis does not absolve you from visiting a medical facility. In any case, effective treatment requires a professional diagnosis. The following methods are currently used:

Skeleton of the free part of the lower limbs.

The femur is the longest tubular bone in the human body. It has a shaft and two ends. At the upper (proximal) end is the femoral head (Caput femoris), which connects to the pelvic bone.

The shinbone (tibia) consists of two bones. The tibia is medial and the fibula is lateral. Every bone has a body and two ends. The ends of the bones are thickened and have surfaces that connect to the overlying thigh bone (tibia) and underlying foot bones. Between the bones is the shinbone space (spatium interosseum cruris).

The shinbone (tibia) is the thickest bone of the lower limbs. The proximal end of the bone is thickened and forms the medial and lateral condyles (condylus medialis et condylus lateralis). The upper articular surface (facies articularis superior) is directed upwards and connects with the condyles of the thigh.

The fibula is thin and has a fibula head (caput fibulae) at its upper (proximal) thickened end. On the medial side of the head is the articular surface of the head of the fibula (facies articularis cdpitas fibulae) for articulation with the tibia.

Foot (pes) is divided into 3 parts: tarsal, metatarsal and toes. The skeleton of these parts consists of the tarsal bones (ossa tarsi), the metatarsal bones (ossa metatarsalia) and the toe bones (ossa digitorum pedis).

bones of the tarsus

The tarsal consists of seven spongy bones arranged in two rows. The proximal (posterior) row is formed by two large bones: the talus and calcaneus. The remaining five tarsal bones make up the distal (front) row.

Tarsal bones (ossa metatarsi). They consist of five short tubular bones. The shortest and thickest is the 1st metatarsal, the longest is the 2nd metatarsal. Each bone is distinguished by its shaft (corpus), head (caput) and base (base). The bodies of the metatarsals are convex and point backwards. The bases have articular surfaces that connect to the tarsal bones.

Like the fingers, the toes have a base segment (phalanx proximalis), a middle segment (phalanx media) and a terminal segment (phalanx distalis).

Ingrown toenail

Toes often hurt because of an ingrown toenail. In this condition, the edges of the nail plate grow into the surrounding skin. The nail digs into the skin, causing redness, swelling, and pain. All symptoms can become worse when infection occurs and the skin becomes infected. To get rid of an ingrown toenail, you need to see a surgeon. Self-treatment in this situation is dangerous, since purulent complications can develop.

Plantar fasciitis is associated with pain in the heel of the foot. It affects a bundle of stiff fibers (fascia) that run under the skin of the foot. Plantar fasciitis often develops after strenuous physical activity such as long-distance running, in people who are overweight or have flat feet, or in the elderly due to age-related wear and tear of foot tissues. Plantar fasciitis symptoms are worse in the morning upon waking and in the evening. This cause of foot pain is treated by an orthopedic traumatologist. Painkillers, special orthoses, physiotherapy and massage are usually prescribed. In particularly severe cases, the pain can be relieved by surgery.

Nerve Damage – Morton's Neuroma

Morton's neuroma is a plantar nerve disorder that causes severe pain at the base of the toes. A tight ring of fibrous tissue is thought to form around the nerves, compressing the nerve. The nerves of the 3rd and 4th fingers are most commonly affected, less often that of the 2nd. Toe pain is made worse by wearing shoes with narrow toes or heels. If you take off your shoes, the pain will subside. See an orthopedist to treat this cause of foot pain.

In older people, recurring bouts of foot pain can be caused by an exacerbation of deforming osteoarthritis, which is one of the most common types of arthritis. Osteoarthritis is associated with the wear and tear of the cartilage in the joints of the feet and toes and the formation of pointed bony growths - osteophytes - at the edges of the bones. The movement of the foot causes pain, which in severe cases can be accompanied by tissue swelling and joint deformity.

Less commonly, foot pain can be caused by rheumatoid arthritis, a type of arthritis in which the immune system attacks the joints, causing inflammation. The disease almost always affects other joints as well, so foot pain is not the only symptom. See a rheumatologist for treatment of arthritis in the foot.

arterial disease

• atherosclerosis of the arteries of the lower limbs;
• Occlusive endarteritis;
• Obliterating thromboangitis;
• Arterial embolism and thrombosis.

Atherosclerosis of the arteries of the lower limbs

Among the diseases of the arteries of the lower limbs, atherosclerosis is the most common, occurring in almost 90 % cases. It is classified as an obliterating vascular disease (obliterating - occluding, clogging). In the past, older men in particular suffered from this disease. Unfortunately, today there is a tendency to rejuvenate the disease, with atherosclerosis appearing already in middle age. Obliterative atherosclerosis is also becoming more common in women.

The risk factors are known: smoking, low physical activity, lifestyle changes, hereditary factors, high blood pressure, coronary heart disease, diabetes, liver and biliary tract diseases, obesity, high blood cholesterol levels.

As the disease progresses, atherosclerotic plaques, made up of cholesterol, other fats, calcium, and connective tissue, form on the inner walls of the arteries. The lumen of the arteries narrows. At rest, the blood flow in the lower limbs can be sufficient, but during physical exertion the increased oxygen demand of the muscles can no longer be met. The muscles respond with pain, causing intermittent claudication. When walking, especially uphill, the calf muscles hurt and the patient has to stand for a while to overcome the pain. If the pain spreads to the whole leg, there is damage to the arteries in the pelvic area. Unlike sciatica, the pain is not related to sudden movements or twists of the trunk.

The pain may be replaced by cramps, weakness, or a feeling of heaviness in the legs.

The legs become cold and pale and have no pulse. In the final stages, trophic ulcers and gangrene can develop. If gangrene develops, amputation of the affected limb may be necessary to save the patient's life. Frequently, amputations, particularly in high closures, are performed at the upper third of the thigh when necrosis develops in the fingers, since in lower amputations it is difficult to achieve healing of the surgical wound.

vein diseases

Varicose veins of the lower limbs

This disease is widespread and poses a very urgent medical and cosmetic problem.

phlebitis and thrombophlebitis

Phlebitis is inflammation of the vein. Thrombophlebitis is a complication of phlebitis or varicose veins in the lower limbs. In thrombophlebitis, a blood clot forms in the inflamed vein. Leg pain and swelling may occur.

Deep vein thrombosis is associated with numerous complications, the most serious of which are venous gangrene of the limb (when all venous drainage pathways are severely blocked and blocked) and pulmonary embolism. The risk of thromboembolism is greatest with an unfixed thrombus - a flotation thrombus. The larger the detached thrombus fragment, the greater the likelihood of an unfavorable outcome, including death.

A common complication of deep vein thrombophlebitis is postthrombotic syndrome.

Head of the phlebological department in the clinic of Dr. Gruzdev. Vascular surgeon and phlebologist of the highest category. Work experience in this specialty – 26 years. Member of the Russian Association of Phlebologists.

diagnosis

In order to identify the disease, it is essential to carry out diagnostics.

This requires the following steps:

1. Collection of the patient's medical history. This will establish whether a similar condition has occurred in the past, as well as the genetic factor;
2. Objective investigation;
3. Subjective investigation;
4. X-rays.

These are the main diagnostic methods to identify a specific foot condition. Without a diagnosis, no treatment can be initiated to avoid worsening the situation.

Why does a flat foot occur?

The causes of flat feet can be divided into two main groups:

The internal causes include, for example, abnormalities in the development of the musculoskeletal system:

• weak connective tissue;
• weakened musculoskeletal system;
• genetic predisposition;
• Insufficient physical activity.

External factors include environmental factors such as:

• Severe and long-lasting physical Heavy and prolonged physical stress on the feet;
• weight gain, obesity or pregnancy;
  uncomfortable footwear. Women are therefore much more likely to suffer from flat feet than men.
  Shoes with a heel higher than four centimeters are uncomfortable, which leads to the development of flat feet - heels higher than four centimeters. However, that doesn't mean that people who exercise can't get flat feet.

Symptoms of foot pain

The clinical picture depends on the underlying disease causing the foot pain.

Osteoporosis and arthritis, for example, manifest themselves as follows:

• Pain occurs that is annoying even at rest and increases when pressure is applied to the heel;
• Upon waking, you will feel stiffness in the joints and numb toes;
• increasing fatigue, including with prolonged immobility of the lower limbs;
• pain in toes after prolonged exertion or inactivity;
• General malaise;
• decreased sleep and decreased ability to work.

Osteoarthritis, gout and flat feet can cause pain in both the plantar and dorsal areas of the foot. Accompanying symptoms:

• swelling of the feet;
• crunching when walking;
• changes in foot shape;
• Sudden onset of pain that becomes acute as the condition worsens and begins abruptly when the foot is at rest;
• rapid fatigue;
• Localized fever in the lower limbs.

If the disease has become chronic, there may also be an overgrowth around the affected joint.

Plantar fasciitis and heel spurs present the following combination of symptoms:

• A feeling of pain is felt, which intensifies when walking;
• The foot is swollen;
• The pains are strongest in the morning hours;
• fever in the extremity.

Arthritis, arthrosis, gout, flat feet and severe overexertion cause pain in the sole of the foot, which is most noticeable when walking. Associated Symptoms:

• Stinging and boring pain is felt;
• swelling of the foot, swelling at the site of pain, local temperature increase;
• As the condition worsens, the pain spreads to the entire ankle;
• Body temperature can rise to 37-38 °C;
• There is a general malaise and signs of intoxication.

Diagnosis and investigations

To determine the cause of the pain, a healthcare professional must examine the patient and assess the nature of the pain. After the anamnesis has been collected, the necessary examinations are selected:

• X-ray examination of the limbs;
• MRI;
• ultrasound of the joint;
• scintigraphy;
• arthroscopy of the ankles;
• myelography;
• Contrast-enhanced discography.

Electrospondylography is used to examine the bioelectrical function of the movement segments of the foot.

structure of the foot

Experts know that the foot has 3 points of contact with the ground, called bony supports: 2 in the forefoot (toes) and 1 in the hindfoot (heel).

The foot is made up of 24 bones, a hundred muscles and a corresponding number of tendons and ligaments that act as shock absorbers for human movement.

The human toes are made up of the phalanges of the foot skeleton, the bones of which extend from the toes to the heel. The tarsal bones are similar to the metatarsals and phalanges, but are less developed because they are less mobile. When walking on the ground, the heel, ie the lateral part of the foot, first encounters an obstacle, then the sole of the foot and finally the toes.

The structure of the foot provides a soft load on the whole body (the longitudinal and transverse arches are responsible for the softness).

Flat feet – the danger for conscripts is the flattening of the (longitudinal) arch, which leads to deformation of the ligament and muscle structure. Unfortunately, flat feet are not the only foot problem people face on their long journey through life.

When feet hurt

Who doesn't know foot pain at the end of a hard day's work? And who hasn't already felt it aching feet after a long walk? Every adult has experienced uncomfortable (and painful!) sensations at some point in their lives.

However, science has agreed to divide foot pain into different types:

General or diffuse, spreading to the whole foot

Diffuse foot pain is sometimes directly related to a specific load or strain (if the feet hurt while walking), but can also occur when the foot is at rest.

Pain as a result of excessive exertion, but without any other clinical signs, is a clear and characteristic symptom of calcium deficiency (osteopathy). Osteopathy can make itself felt in those affected: rickets, osteoporosis in the elderly, osteomalacia.

An uncommon but notable symptom is that the bones are painful even to palpation or simply to pressure.

Diffuse pain is also caused by:

• Long bed confinement in case of illness. Here the problems are not due to bone pain, but to a weakness in the muscular system.
• Weight gain with short periods of movement.
• Osteoporosis due to tissue damage (bone or soft tissue) or joint damage in the ankle group (or its condition).
• Organically caused vascular diseases that impair the function of the system. The pain is variable over time and occurs intermittently.

Pain that is localized to a specific spot (the size or extent of the spot is not important)

Pain in feet and toes and precise localization, ie the location of the pain is at a specific point - and this has various causes. Touching and squeezing the toes is the basis of diagnosis, which helps to find out - and eliminate - the nature and cause of the pain.

What does foot surgery specialize in?

The most important specialty is diseases of the foot.

Most people have a very distant and vague idea of such diseases.

Of course, everyone knows flat feet. But more than the fact that it is a 'congenital defect that cannot be cured' is not something many can say.

But even with such a superficial presentation, there are more misunderstandings than truths.

• First, congenital flatfoot accounts for only three percent of all cases. The rest are acquired cases. The causes of acquired (lifetime) flat feet can be traumatic, paralytic, rickets or static. The banal factor behind static flat feet is being overweight.
• Second: flat feet can be treated! Even conservative treatment, if started on time and carried out thoroughly, can eliminate a defect that has manifested itself in a mild form. Even moderately severe and severe forms that were considered untreatable in the last century are treatable today thanks to modern surgical techniques that are well developed in Germany and are available to all patients, including those from abroad.
• Thirdly, flatfoot is not a single clinical picture, but a whole complex of structural disorders of the foot (transverse flatfoot, longitudinal flatfoot, etc.). In addition, German orthopedics distinguishes a number of other foot diseases that are both related to flatfoot and completely independent. This increases the risk of complex foot defects. For example, longitudinal flatfoot with valgus deformity of the first toe. Or a valgus deformity with limited mobility of the first toe. In such cases, surgical correction is all the more necessary, since conservative treatment is powerless against serious, complicated injuries.

The structure of the foot can be corrected quickly and reliably in a minimally invasive manner, i.e. almost painlessly, especially in children.

foot defects

The initial need for surgical treatment of the foot and the choice of specific techniques depend not only on the severity of the foot defect but also on its type. In some cases, surgical correction is the first choice, in other cases, conservative treatment is given at first, and surgical treatment is recommended only in the case of inexorable progression of the pathology.

• flat foot;
• valgus deformity of the first toe;
• Impaired mobility of the first toe;
• high foot;
• clubfoot
• clubfoot 'outside';
• high heel;
• persistence of the little toe;
• stiffness of toes;
• metatarsalgia (pain in the forefoot);
• Morton's neuroma;
• pain in heel;
• Charcot disease;
• ingrown toenails.

• Structure of the human foot.
• structure of the toes.
• The tarsal bone hurts from above - what to do?.
• structure of the toes.
• Structure of the human lower limbs with captions.
• Determining the number of longitudinal arches in the human foot.
• Longitudinal and transverse arches of the foot.
• Which ligaments strengthen the transverse arch of the foot?.