Flat feet

　　Flat feet can be congenital or acquired, and the general causes of the disease include the following points:

　　1. Genetic factors:Those with flat feet and an incorrect load line from birth generally have no symptoms, but only when the degree of flat feet is severe or the objective conditions are unfavorable, symptoms may appear, gradually from mild to severe, and eventually lead to traumatic changes in the foot joints, with a reduction in joint activity and even disappearance. In this case, one or both parents may have flatfoot syndrome.

　　2. Congenital bone deformity:Common bone deformities include the enlargement of the navicular tuberosity, separation of the accessory navicular bone or the ossification center of the navicular tuberosity, which can weaken the support force of the posterior tibial muscle and the stability of the elastic ligament, causing the talus head to descend and incline medially, and the sole to be everted. In addition, a short first metatarsal bone, congenital talus bridge, and other factors can also cause flatfoot syndrome.

　　3. Acquired or wear-and-tear type:The arch of the foot and the load line are normal, but if the foot's internal and external load muscles are weak, they often trigger flatfoot syndrome. Factors causing weakness of the foot muscles include malnutrition, muscle weakness after a long illness, sudden significant weight gain, poor posture of standing or walking, and other factors.

　　4. Medial toe;The Achilles tendon shortens, the heel cannot touch the ground, the load line also moves inward, and with infection, unsuitable shoes, ankle sprain, sudden overloading, long-distance walking, exceeding one's own endurance, the muscles and tendons are inevitably pulled, causing severe pain in the foot, obvious edema, and muscle spasm. Initially, it is an acute foot strain, that is, pain and fatigue in the arch of the foot, which can be restored after rest, physical therapy, and other methods to improve blood circulation. If not treated properly, it may lead to spasm of the longus muscle of the fibula, deformity of the foot abduction and eversion, reduction in the activity of foot adduction and inversion, the foot becoming rigid in the position of eversion, and finally, the occurrence of traumatic changes in the bones and joints. This type is also known as spastic flatfoot syndrome.

　　The complications of flat feet usually occur after adolescence. Due to the sharp increase in body weight and activity, the soft tissues of the foot are repeatedly subjected to excessive loads, thus causing chronic muscle strain of the foot, tendinitis (especially tendinitis of the posterior tibial muscle), plantar fasciitis, metatarsalgia, and other complications. In severe cases, it may also cause osteoarthritis.

　　According to the different onset time, the manifestations of flat feet are also different. The common manifestations are introduced as follows:

　　1. Postural flat feet

　　In the early stage of onset, there is no abnormality in the appearance of the arch of the foot, but only a feeling of fatigue and pain in the feet after standing and walking for a long time, with swelling of the sole and the back of the foot. Generally, after rest, it can completely disappear.

　　2. Spastic flat feet

　　In the middle stage of onset, it develops from postural flat feet, mainly manifested as spasm of the lateral muscle group, the foot presenting in the positions of eversion, abduction, and plantar flexion, the arch of the foot collapsing, pain intensified, and both walking and standing cannot be sustained for a long time. After rest, it cannot be completely relieved.

　　3. Rigid flat feet

　　In the late stage of onset, it develops from improper treatment of the above two types, with the muscle of the calcaneus becoming rigid, the interosseous ligaments of the foot also becoming rigid, causing the foot to be fixed in the positions of eversion, abduction, and plantar flexion, with the arch of the foot disappearing, difficulty in walking and standing, and pain reduced. Due to the disappearance of the normal function of the foot, it cannot absorb shock, and traumatic arthritis of the lumbar and lower limb joints may occur, causing pain.

　　There are many treatment methods for flatfoot, and most of them have certain curative effects, but there is still no treatment method that can satisfy people very much, so it still emphasizes prevention first. It is recommended to perform functional exercises of the intrinsic and extrinsic muscles of the foot in daily life, such as foot plantar walking, plantar flexion exercises, and toe-dragging exercises. At the same time, choose shoes with good arch support and avoid standing for too long, which are all of certain significance for the prevention of flatfoot.

　　Flatfoot can generally be diagnosed by X-ray, and X-ray films can show the following bone and joint deformities:

　　1. The first cuneiform bone and the first metatarsal bone are separated from the median line (leaning towards the inside).

　　2. Talus calcaneal overlap, manifested as destruction of the transverse arch.

　　3. The space between the first cuneiform bone and the first metatarsal bone disappears, manifested as talus varus and calcaneal varus.

　　4. Subluxation of the tarsal interosseous joint.

　　5. Hallux valgus.

　　6. The metatarsal angle reaches 105°～120°.

　　7. The arch index is less than 0.29, and severe cases can be less than 0.25.

　　Diet has no special effect on this disease. It is recommended that patients only need to eat a reasonable diet. If patients choose surgical treatment, they should adopt a nutritious diet after surgery to accelerate recovery. The diet of patients should be light, easy to digest, eat more vegetables and fruits, reasonably match the diet, and pay attention to sufficient nutrition. In addition, patients also need to pay attention to avoid spicy, greasy, and cold foods.

　　There are many treatment methods for flatfoot, and most of them have certain curative effects, but there is still no treatment method that can satisfy people very much, so it still emphasizes the treatment principle of prevention first:

　　1. Postural flatfoot is generally treated conservatively, eliminating the cause, and providing physical therapy, massage, exercise of the intrinsic and extrinsic muscles of the foot (such as walking and jumping on the beach or using the toes to grasp small balls, etc.), wearing corrective shoes, or using arch supports.

　　2. For patients with spastic flatfoot, foot therapy and massage should be performed. For severe cases, manipulation correction of hallux valgus, abduction, and extensor deformities can be performed under anesthesia, and short leg casts are fixed in the varus and adducted position. After the deformity is corrected (usually 6-8 weeks), the cast is removed and corrective shoes are worn. For patients who do not respond to non-surgical treatment, surgical treatment can be performed, such as Miller surgery, triple arthrodesis, etc.