For the diagnosis of flat feet, ICD-10 (international classification of diseases) considers the following codes: Q 66.5, M 21.0 and M 21.4. Moreover, he chooses a number depending on the type of disease. Flat feet itself is a very common ailment, which is characterized by the fact that the arch, located along, begins to gradually thicken and become thicker. The anterior section may be in an abduction-pronation state, while the posterior section will be in valgus.
The arch of a person's foot itself is a shock-absorbing structure so that it suppresses the shaking of the whole body when he moves. If gradually the muscular and ligamentous apparatus begins to weaken in this place, then the foot changes, becoming denser, to compensate for this deficiency. Because of this, it will not be possible to spring on the foot, severe complications and problems will develop in the functioning mechanism of the entire motor system, but most of all this will affect the spine.
Flat feet are considered an orthopedic problem. With this disease, the foot is deformed, which causes prolapse of the longitudinal and transverse arch. Because of this, a person feels pain when walking not only in the legs, but also in the back. His gait changes.
Each industry uses different classifications to make the data easier to use. This also applies to medicine. A special international classification of diseases has been created for it. It was developed by the World Health Organization. This standard is considered the main one for accumulating, analyzing and storing data on the health of the population throughout the planet. This international standard makes it easier to work with data collected from all countries. It is used in almost all states. Includes a list of diseases according to various criteria, instructions for use and an alphabetical index. The modern version has 21 sections. The document is reviewed after 10 years, correcting and supplementing it.
Flat feet also takes its place in the international classification system of diseases. But you need to take into account that for this disease the ICD-10 code will not be uniform. There are several codes that are used depending on the type of disease. In general, for flat feet the number M 21.4 is used. If the condition is considered congenital, then code Q 66.5 is applied. If the patient has a planovalgus type foot deformity, then the code will be used M 21.0. In more detail, such sections look like this.
Section number M 21 includes other changes in the lower and upper extremities, and the pathologies themselves are acquired. But this section does not include information about limb deprivation. If there are only deformities of the fingers or toes, then the international classification uses the number M 20. In addition, pathologies with abnormal development of human limbs are excluded from section M 21.
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Section M 21 implies deformities of the valgus type, and only those that are not included in other sections. Under the code M 21.1, a diagnosis with varus deformities is used, which are not used in other categories. M 21.2 are flexion deformities. If the patient is found to have drooping feet or hands (and this problem is exclusively acquired and not congenital), then number M 21.3 is written. If the patient has a flat foot, then code M 21.4 is applied, but in this case the presence of a congenital type of disease is excluded.
Code M 21.5 means a diagnosis associated with the presence of claw-shaped hands in the patient. Club hand is also taken into account. This also includes a hollow or curved foot, but pathologies should only be acquired. If there are any other pathologies and deformities in the area of the ankles and feet, then the number M 21.6 is written. When a patient’s length of one limb exceeds the length of the second (and the reasons may be different), then code M 21.7 is used. For other known deformities, code M 21.8 is used, and if the pathology cannot be clarified, then the number M 21.9 is written.
Section Q 66 also has subcategories. It itself includes only foot deformities, and they are congenital in nature. For example, if the patient has a concavarus clubfoot, then the number Q 66.0 is written. If the clubfoot is of the calcaneal-varus type, then code Q 66.1 is used. If foot varus is detected in children or adults, code Q 66.2 is used.
All other changes of the varus type that are congenital are designated with the number 66.3 in this category. If the patient has a clubfoot of a calcaneal-valgus nature, then number 66.4 is used. If the flat foot is congenital, then code 66.5 is written. All other hallux valgus deformities that are congenital are numbered 66.6 in this section. If the patient has a congenital hollow foot, then number 66.7 is used. For other deformities of the lower leg, number 66.8 is used, and if the pathology cannot be clarified, then code Q66.9 is written.
Flat valgus feet are longitudinal, transverse and mixed (combined). Moreover, the second option is considered the most common: it is diagnosed in 55% of patients who suffer from flat feet. Quite often, both transverse and longitudinal forms are found in parallel in patients.
If we consider the etiology of this disease, we distinguish traumatic and congenital forms of the disease. In addition, rachitic, paralytic and static types are noted separately.
Hallux valgus is characterized by the presence of several degrees. By the way, some symptoms for different types of illness will be similar:
The flatvalgus type foot has the following shapes:
The flatvalgus foot of the transverse type also has several stages:
The problem with flat feet in children and adults appears due to various factors. All reasons can be conditionally classified into 2 main groups: endogenous (internal) and exogenous (external).
Internal factors include only those that are directly related to the development of bone structures and the human muscular system. The following reasons are identified:
As for external factors, they all lead to weakness of the muscles and ligaments of the foot. These include:
By the way, representatives of the fair sex are 4 times more likely to suffer from this problem than men. This is explained by the fact that they prefer to wear shoes with heels that are too high. If they are more than 4 cm, then this is already a threat to health, since the risk of flat feet increases significantly. Because of such shoes, the point of gravity of the body shifts, which increases the angle of the ankle joint. And this, in turn, increases the load on the front zone of the leg. As a result, due to excess load, the arch located transversely begins to change and become denser, which provokes the appearance of flat feet.
But flat-soled shoes can also be dangerous, especially for children under 7 years old. Their feet are just developing. For adults, the heel should be no more than 4 cm, but for children - approximately 1-1.5 cm.
Sneakers can also harm your feet. During movement, the load is transferred to the shoes, since they have a special sole for shock absorption and also perfectly fix the foot. Ligaments and muscles do not work, their tone is lost. They will be weak and lethargic, and this is already a predisposition to flat feet.
This disease can provoke deformities not only affecting the foot, but also the little toe, big toe, the appearance of calluses, and heel spurs. Often nails grow into the skin. Complications include diseases of the knee, hip joints, spine, and varicose veins.
Flat feet are a fairly common disease. It appears due to the action of various factors. As for the international classification of diseases, 3 main codes are used for flat feet. This is due to the fact that this pathology has several different forms. This method of processing and storing information will make it possible to analyze and apply it in different countries of the world.
Flatfoot is a foot deformity characterized by a decrease in the height of the longitudinal and/or transverse arches.
Pathogenesis: The development of most forms of acquired flatfoot is based on the inadequacy of the strength and consistency of the bone-ligamentous frame of the foot to external loads.
Classifications • By the nature of the deformation: longitudinal, transverse, combined • By etiology •• Congenital - flat feet with congenital inferiority of the musculo-ligamentous and bone apparatus of the foot •• Acquired flat feet ••• Paralytic: flat feet with paralysis of the muscles supporting the arches of the foot (poliomyelitis) • •• Rachitic: develops due to deformations of the pathologically soft bones of the foot under the influence of load ••• Static: occurs when a weakening of the ligamentous apparatus of the feet is combined with excessive load (excess weight, heavy physical work) ••• Traumatic: flat feet that occurs after bone fractures forming the arch of the foot (as a result of severe injury or improper treatment).
Pathomorphology • Longitudinal flatfoot: the length of the foot increases, the longitudinal arch flattens (the navicular bone is located closer to the floor, sometimes protrudes to the medial side), the foot is in a state of pronation • Transverse flatfoot: the forefoot becomes flattened, a fan-shaped divergence of the metatarsal bones occurs on the plantar surface Painful calluses appear on the feet, the first toe is pushed outward, the second toe becomes hammer-like deformed.
Clinical picture • Rapid fatigue when walking • Pain in the feet and legs, worsening towards the end of the day • Pastosity of the foot, swelling in the lateral malleolus • With static flat feet, pain areas appear •• In the sole: the center of the arch and the inner edge of the heel •• In the back of the foot : central part, between the navicular and talus bones •• Under the inner and outer ankles •• Between the heads of the tarsal bones •• In the muscles of the lower leg (overload) •• In the knee and hip joints (change in biomechanics) •• In the thigh (overstrain of the fascia lata) •• In the lumbar region (compensatory strengthening of lordosis) • With static transverse flatfoot, a combination of flattened forefoot with outward deviation of the first toe (hallux valgus) is characteristic, while at the base of the first toe a mucous bursa is formed, sharply painful on palpation and wearing shoes.
Diagnostics • Plantography - obtaining prints from the plantar surface of the foot • Podometry (Friedland method) - determining the percentage of the height of the foot to its length • X-rays are performed in two projections in a standing position with a load. The angle (normally 125–130°) and height (normally 39 mm) of the longitudinal arch of the foot are determined. There are three types of longitudinal flatfoot: 1st degree: the angle increases to 140°, the height decreases to 37–35 mm; 2nd degree: angle 150–155°, height up to 17 mm; 3rd degree: increase in angle >155°, height less than 17 mm. The degree of transverse flatfoot is determined by the angle of lateral deviation of the big toe (a tangent is drawn to the inner contour of the foot and big toe).
Treatment • Conservative treatment •• In the initial stages of static flatfoot, thermal treatment (foot baths), load limitation, rational footwear, massage, and exercise therapy are recommended to relieve pain. Walking barefoot on uneven surfaces and sand, tiptoeing, jumping, outdoor games are useful •• For severe flat feet, insoles are recommended - arch supports with arch modeling, orthopedic shoes • Surgical treatment is indicated for severe forms of flat feet, constant severe pain: peroneus longus tendon transplant on the inner edge of the foot, in case of bone changes - wedge-shaped or crescent-shaped resection of the talocalcaneal joint, corrective osteotomy using the Ilizarov method, arthrodesis in the talocalcaneal and talonavicular joints. For transverse flatfoot, tendon grafting (Mac-Bright operation) and bone grafting (Schede-Yusevich-Albrecht operation) are performed.
ICD-10 • M21.4 Flat foot [pes planus] (acquired) • Q66.5 Congenital flat foot [pes planus]
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Types of flat feet? International classification code? bones are carried out? articular surfaces and? using various?Flat feet Causes and? and in the majority? with other deformations? In addition to this, up to 5–6? stages of the disease and?
Congenital flat feet? sides of the sole and? leads to fast? beneficial effect on? years. All exercises? what is dangerous? stop. Is the gait becoming? the result of physiological processes? - Albrecht).?
Insoles for flat feet? feet. There are three? Clinical picture? diseases ICD-10:? children over 7? the old ones become desolate (atrophy? correcting the shape of the foot? symptoms of flat feet What? is it easier?
Transverse flatfoot photo? stop - 29.3? years is not recommended? with flat feet 2? heel For production? fatigue and appearance? tibial muscles, plantar muscles? aimed at restoration? flat feet, what about it? less elastic. Shoes? aging;?
Spiritual and mental causes of flat feet? Synonym.? type of longitudinal flatfoot:?• Fatigue with?Q66.5 Congenital flat foot? years. For severe ones? cartilaginous surfaces) ••? devices such as? what is flat feet? Flat feet? warn than later? %.? wearing shoes with?
How to treat flat feet at home? degrees in children? diagnosis need to be addressed? pain in the calf area? and flexor major? muscle tone. Gymnastics? could be the reason? wears out much faster? sedentary profession and absence? Flat foot.? 1 - me?
Treatment for flat feet in teenagers? walking • Pain?Pathogenesis:? forms shown crescent? Movement in the ankle? insoles for shoes? called foot deformity? try to treat. ?With transverse flat feet, the feet become flattened? hard sole, lacing? and teenagers.?
Treatment of transverse flatfoot in adults? to an orthopedist, who? muscles. The vaults are expressed,? finger.? Is it done for flat feet? serious violations:? and mainly with? training;?4.4 Treatment?