pathology: talipes foot

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talipes foot (Pes valgus)

As the buckling foot is usually associated with a flat foot or even a flat foot, see also under flat foot.

Definition of

Increased eversion in the subtalar joint between the talus and calcaneus, medial-plantar twisting of the talus, i.e. in pronation, resulting in increased valgus position of the heel (the medial edge is lowered), usually occurs in childhood (a reversible kinked foot position is physiological up to the 7th year of life) and sometimes, but not always, develops, must be observed and treated if necessary. The kinked foot often occurs together with flat or fallenarches and in adults is often the result of tibialis posterior syndrome(tibialis posterior dysfunction). The peak incidence is in women over the age of 40. W:M 3:1.

ICD Q66.6

Cause

  1. Ligament weakness of the subtalar joint, tibialis posterior syndrome (PTTD): Tendon weakness of the tibialis posterior, which helps to keep the foot in shape
  2. Trauma, e.g. sports injury
  3. Infections
  4. Bone diseases

Predisposing

  1. Diabetes mellitus
  2. arterial hypertension
  3. Long-term cortisone intake
  4. Severe overweight
  5. rheumatic diseases

Diagnosis

  1. Muscle strength testing, clinical function tests
  2. Pedobarography (static and kinetic representation of the pressure conditions on the sole of the foot)
  3. Sono (shows inflammation), MRI, X-ray (shows bone position)
  4. Tests and signs: too many toes sign, single heel rise test, foot flexibility test

Symptoms

  1. Often clinically inapparent for a long time
  2. symptoms of tibialis posterior syndrome often appear, see also there
  3. Prominent medial malleolus, the talus becomes visible under the medial malleolus
  4. possibly load-dependent pain in the area of the inner foot or inner ankle, possibly radiating into the lower leg
  5. Knee pain occurring after a short period of exertion
  6. Medially emphasized wear pattern of the shoes

Complications

  1. bow legs or knock knees
  2. Knee damage
  3. Scoliosis
  4. Hyperlosorization of the lumbar spine

Therapy

  1. Insoles in a sturdy shoe (!)
  2. Kyrotherapy, ultrasound therapy
  3. PT
  4. Splinting
  5. Steroids against inflammation
  6. if necessary OP
  7. Frequent barefoot walking, especially on uneven natural surfaces

Asana practice and movement therapy

Since the tibialis posterior syndrome (PTTD) is predominantly the pathomechanism by which the buckling foot develops, see the recommendations given there.