equinus

Spitzfuß – orthopedic problems

The equinus (Pes equinus = horse foot) is characterized by the fact that the heel can not touch the ground when standing. The medical name stems from the fact that horses also run only on their toes, more precisely on the middle toe, which corresponds to the hoof. The toe gear causes great problems for people, because the whole body weight then weighs on the front foot part. When walking, the foot is not unrolled. The result is an unstable standing and a bad load, for which the feet are anatomically not prepared.

Spitzfuß – innate or acquired?

The Spitzfuß can be innate or acquired.

An innate Spitzfuß is usually based on one malformation, Either the lower leg bones or the Achilles tendon are not sufficiently developed or there was a forced malformation of the unborn child in the womb.

Mostly, however, the Spitzfuß is acquired, that is, it develops only after birth. Different diseases can affect the nervous system and thus one Low supply of the foot muscles cause it to be able to unroll the foot. When the nerve supplying the large calf muscle (peroneal nerve) is damaged, it also causes a foot of pout.

Disorders affecting the nervous system can also cause a paralysis cause. For example, hemiparesis often occurs after a stroke, which can cause a pointed foot. Cerebral palsy, which occurs, for example, as a result of trauma or lack of oxygen during childbirth, can also be the cause of foot deformity.

In addition, other diseases can be triggers for the Spitzfuß. An example is hemophilia, where blood clotting is delayed. When hemorrhages in the calf muscles nerves can be pulled, which can cause paralysis.

at accidents or traumatic injury Nerves passing through the calf muscles can be injured. This, as well as damage to the ankle or foot muscles, can result in a pointed foot.

Especially elderly patients, the long time bedridden are, their feet are no longer sufficient. This leads to a shortening of the Achilles tendon. The duvet presses the toes and the back of the foot slightly forward and reinforces the posture.

In addition, some children get used to walking on their toes, but this disappears with the growing mostly by itself again.

Spitzfuß – the diagnosis

The pointed foot can often be diagnosed with the naked eye. A muscle examination (electromyography), in which the electrical voltage is measured, helps to identify muscular causes for the Spitzfuß. An x-ray examination shows how far the bony structures are involved in the malposition. The knee joint and the hip joint should also be X-rayed if necessary. They may already have been affected by the Spitzfuß attitude.

Spitzfuß – that is how he is treated

In general, every form of pointed foot is treated. However, if there is a unilateral leg shortening, this must not be corrected.

Which treatment is best for each individual case depends on the severity of the malposition, the cause and the symptoms. Conservative and surgical treatment methods are available:

The non-invasive (conservative) treatment consists primarily of physiotherapy, It tries to alleviate the Spitzfuß by active and passive stretching in the lower leg and bring the foot in its normal position. If the physiotherapy is not sufficient as a treatment, a lower legstanding plaster created. This plaster cast leads the Spitzfuß over a longer time and in stages back to its original position.

If the conservative methods do not bring the desired success, one becomes surgical intervention necessary. Under anesthesia, the Achilles tendon is lengthened. Following the operation, a cast for stabilization will be created for about four weeks. Subsequently, the application of a night rail is recommended to counteract a regression. This treatment method is very successful, especially in children.

In adults who suffer from a Spitzfuß, one can additionally consider an operative joint stiffening (arthrodesis). The upper ankle is stiffened. The lower ankle is maintained in its mobility, whereby the foot remains mobile. However, this surgical procedure should only be used when the articular cartilage has already been severely worn by the pointed foot.

If the results of the above therapies are inadequate, the equinus must be using orthopedic shoe inserts be compensated. This is a wedge-like insert placed in the shoe to allow a normal gear.

Spitzfuß – Healing chances

Children who have become accustomed to walking on the front foot have a good prognosis: As they get older and heavier, walking on tiptoe becomes more and more difficult and they usually get used to themselves.

If, for example, the pointed foot is caused by nerve damage or paralysis, intensive physiotherapeutic treatment is required to prevent consequential damage to the knee and hip joints as well as the spine due to the crooked gait pattern. However, the Spitzfuß can not be completely healed.

Prevent Spitzfoot

You can actively prevent a pointed foot. For longer bed rest you can attach a footboard in the bed, on which the feet are supported, thus preventing the Spitzfuß attitude. In addition, regular stretching exercises of the calf muscles bend one equinus in front.