Flatfoot is a foot deformity that is characterized by lowering the transverse and longitudinal arches.
In this case, deformation of only the longitudinal or only the transverse arch is possible, but there may also be simultaneous deformation of both arches. The more common form of transverse flatfoot.
When many people hear the diagnosis of “flat feet,” they despair. But don’t be too upset, because if the problem is detected in a timely manner and the correct treatment is selected, positive changes are guaranteed. Of course, it will take quite a long time to treat flat feet; in some cases, surgical operations are possible, but in the end it is possible to restore a crooked foot.
The human foot is built in a special way that provides shock absorption while walking. This feature is unique to humans. No animal has such springy feet.
This springiness is ensured by the presence of two arches of the foot: longitudinal (located on the inside of the foot) and transverse (located between the bases of the toes). The normal position of the foot is maintained by a system of muscles and ligaments.
If the foot is not deformed, then it fully reduces shaking when walking and helps maintain balance. If the muscular-ligamentous apparatus of the foot is weakened, then the foot is deformed under the weight of the body, becoming almost or completely flat, thereby losing its shock-absorbing properties.
Flat feet have quite a few causes. Chief among them is poor tone of the ligaments and muscles of the foot, as a result of which they are unable to support the arches of the feet in a normal position.
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Risk factors for developing the disease may include:
There are several types of flat feet.
First of all, acquired and congenital flat feet are distinguished. The second type is extremely rare and requires immediate treatment immediately after the birth of the baby. Its cause is an intrauterine disorder of the development of the musculo-ligamentous apparatus.
Acquired flat feet can appear at any time in a person’s life. There are several types of it:
As the name implies, the cause of the development of traumatic flatfoot is a previous leg injury. This may include injuries and fractures of the ankle and foot bones. Damage, sprains or tears of the muscles and ligaments that form the arch of the foot can also cause such flat feet.
Flat feet of a rachitic form arise as a result of rickets. This disease leads to disruption of the proper formation of the bones of the foot, which become soft and fragile. Because of this, the foot becomes deformed and its arches become flat.
Paralytic flatfoot occurs after poliomyelitis. It can also cause paralysis of the tibial and foot muscles.
The static form of flatfoot is the most common. It arises due to insufficient development of the musculo-ligamentous apparatus of the foot.
In addition to this classification, there is also a classification depending on which arch becomes flat. There are transverse, longitudinal and combined (longitudinal-transverse).
In more than half of cases, flat feet occur in a transverse shape. This type of deformity is most common in people aged 35 to 50 years, but can also occur in other age categories. At the same time, the transverse arch of the foot flattens, it becomes shorter, and the first toe deviates to the side.
In 1/3 of cases, longitudinal flatfoot develops. It is more typical for young people aged 15 to 25 years. The foot becomes flat, the longitudinal arch disappears and the leg increases in size. The manifestation of the disease significantly depends on the person’s body weight - the higher this weight, the more pronounced the deformation.
There are several degrees of flat feet:
Features of transverse flatfoot:
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Foot deformities lead not only to gait disturbances. Flat feet cause many unpleasant and painful sensations:
If you suspect flat feet, you can check the condition of your feet at home. This, of course, will not be a 100% diagnosis, however, it may be a reason to seek help from a doctor.
To diagnose flat feet at home, you will need oil or a thick cream and a sheet of clean paper. The feet are lubricated with cream or oil. Place the sheet on a flat, hard surface and stand on it. If more than ? width of the foot, then most likely flat feet occur. It is necessary to consult a doctor to obtain a more accurate diagnosis and prescribe appropriate treatment.
The diagnosis of “flat feet” can only be made by a doctor based on x-rays in 2 projections with a load (in a standing position). In addition to x-rays, a physical examination and interview of the patient is performed. In this case, the orthopedist determines the correct location of the feet and lower legs, the angles of deviation of the foot, range of movements, gait features, as well as the condition of the shoes (especially their wear).
In 2014, the requirements for conscripts suffering from flat feet were increased.
Thus, only the following can serve as exemption from conscription:
If a conscript has grade 2 flat feet, then he is fit for military service with some restrictions. He simply won’t be accepted into the navy, special forces or paratroopers. In all other troops his service is possible.
In 2016, the standards for conscripts did not change, which means that young men with flat feet in the initial stages will have to serve in the military.
Treatment of longitudinal and transverse flatfoot is practically the same. It is important to take into account that treatment for an adult can only alleviate the condition and slightly remove flat feet, but a complete recovery cannot be expected.
But treatment of children makes it possible to completely restore normal arches of the feet, because they are in the process of growth and their correction is quite possible and effective.
Treatment for flat feet begins immediately after the diagnosis is made. After all, it is very important to stop further deformation of the foot in time.
The treatment is complex and has 2 directions: eliminating pain and strengthening the muscular-ligamentous system.
To relieve pain due to flat feet, medications from the NSAID group are prescribed, for example, Diclofenac, Ibuprofen, Ketanov, Dikloberl, etc.
The use of phonophoresis, electrophoresis, magnetic therapy, massages, mud treatment, hydromassage, etc. has a positive effect on flat feet. These procedures improve blood flow and tissue nutrition, and also increase the tone of the muscles of the lower leg and foot.
Therapeutic gymnastics forms the basis of treatment. A set of exercises is selected in each case separately, depending on the degree of flat feet, the physiological characteristics of the patient and the presence of concomitant diseases.
Exercises are performed daily. Therefore, those who want to improve the condition of their feet should be prepared to work on their ailment for a long time. This is not a disease that can be cured with medications. For noticeable improvement, the patient's work is necessary.
Often, in combination with exercises for the feet, general strengthening exercises for the whole body are prescribed.
People suffering from flat feet are recommended to wear special orthopedic insoles. They are selected by an orthopedist depending on the type of deformity.
Warm foot baths with sea salt also have a positive effect on flat feet.
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In the most difficult cases of flat feet, a surgical solution to the problem is recommended. However, this method is very traumatic and is not able to restore lost tone. There are quite a few surgical operations to eliminate it. They all involve tendon transfer, removal of protruding bone, plastic surgery of the joint capsule, or changing the angle between the bones of the transverse arch of the foot.
The basis of treatment for flat feet in children are massages, gymnastics and wearing special shoes. In some cases, special splints or plaster casts are used.
No one is immune from developing flat feet. But everything is in our hands! If you take preventive measures and maintain the tone of the musculo-ligamentous apparatus of the foot, then you don’t have to worry about the development of this foot deformity.
Prevention of flat feet may include:
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In the early stages, flat feet do not cause significant discomfort. Therefore, many people usually ignore it. In fact, it is sluggish in nature, that is, it develops gradually. Level 3 flat feet are characterized by many unpleasant symptoms, such as severe pain, changes in gait and deformation of the foot. Let's look at why flat feet develop, as well as methods of treating it at stage 3.
In the early stages, the disease is easily treatable, but under the influence of unfavorable factors it begins to progress, leading to grade 3 flatfoot. These are:
The above factors provoke flat feet in people with a predisposition to this disease.
Depending on the type of pathology, the patient experiences the following symptoms:
Any form of third-degree pathology requires long-term complex therapy. Therefore, during the treatment period, you should be patient and strictly follow the instructions of your doctor.
How to treat this stage of the disease? This requires long-term complex therapy, which includes the following methods of influence:
Is it possible to cure third degree flat feet without surgery? Advanced forms of the disease require exclusively surgical intervention. Therefore, in order to avoid surgery, it is necessary to contact a specialist in a timely manner.
In the early stages of the disease, parents usually begin effective treatment for their children. But it does not always give the desired result. The pathology gradually transforms into grade 3, which is difficult to treat. This diagnosis is not made for children under 8 years of age. Before this period, the child’s foot is not yet fully formed. The operation is not performed on children. For a complete recovery, long-term treatment is required, which consists of regular therapeutic exercises, physiotherapy, wearing orthopedic shoes, and massage.
Stage 3 pathology in a teenager should also be treated for a long period of time. The therapy prescribed is the same as for an adult. Only in extreme cases is it necessary to resort to surgery.
Will they be accepted into the army with this diagnosis? Both longitudinal and transverse flat feet of the 3rd degree provide for complete exemption from service. Pain sensations are not even taken into account, unlike the milder stages of the disease. Therefore, a potential conscript with such a disease can be sure that he will not serve in the army.
Many young people are not eager to serve in the army. They are looking for all possible options to avoid this. Therefore, they are interested in how to make 3rd degree flat feet on an x-ray? After all, an X-ray examination is carried out in a vertical position, without leaning on anything.
In order for the result of the x-ray to show stage 3 disease, it is necessary to take a long walk on your feet before undergoing the examination, preferably with a load in the form of a heavy backpack. It is the missing few centimeters that can be “increased” in this way for a while.
When diagnosing this disease, in extremely rare cases, disability is given. This is due to the fact that during its development, the skin becomes flattened, but the inside of the ankle joint retains its integrity. But with grade 3 flat feet, deformation of the foot occurs, which leads to the appearance of concomitant diseases, such as scoliosis, osteoarthritis, etc.
To receive disability due to pathology, a person must undergo an X-ray examination, examination by a surgeon, orthopedist and neurologist, as well as pass all the required tests. Usually, according to the results of studies, in the presence of severe pain, the patient is assigned disability group 3. It provides for easy work. As for the advanced form of flatfoot, accompanied by arthrosis, in this situation, disability group 2 is assigned.
To summarize, it should be said that this stage 3 disease requires long-term complex treatment. The disease is accompanied by severe pain when walking, sometimes at rest, which significantly interferes with everyday life. And ultimately, it leads to such an unpleasant consequence as disability. Therefore, it is better not to neglect flat feet, but to begin treatment at the first characteristic symptoms.
Clubfoot is one of the orthopedic problems that arise during the formation of the child’s musculoskeletal system in the first years of life.
Such an illness can radically change a child’s quality of life and create a risk of developing serious problems in adulthood.
Prognosis for the treatment of clubfoot depends on the degree of progression of the pathology and the reasons that provoked its appearance. The disease must be corrected when its first signs are identified. We will talk about the treatment of clubfoot in children in this article.
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In medical practice, clubfoot refers to the deformation of one or two feet, causing their incorrect position and deviation to the inside .
The disease can be not only congenital, but also acquired . With clubfoot, serious deformation occurs not only of the bones, but also of the muscle tissue. In most cases, the pathology affects both legs of the child.
Numerous factors can provoke clubfoot, including pathologies associated with intrauterine development of the fetus .
The disease is a consequence of improper formation of the bone skeleton, muscle tissue and joints.
In some cases, the pathological process is a consequence of a disorder in the condition of certain groups of nerves or blood vessels. In medical practice, there are cases where the causes of clubfoot in a child cannot be determined.
The following factors can cause
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Depending on the stage of progression of the disease, clubfoot is divided into mild, moderate and severe . The first form is characterized by minor changes in the musculoskeletal system.
The second stage is accompanied by more intense symptoms and difficulty moving the ankle joint.
Severe degree is characterized by pronounced pathology and can only be eliminated by surgical intervention.
Other types of classification of clubfoot in children:
Symptoms of congenital clubfoot appear in a child already in the first months of life. Signs of the disease are clearly visible visually , so parents may suspect a pathology before a routine medical examination of a newborn or infant.
Symptoms of acquired clubfoot may appear in a child during the first year of life or in preschool age.
Clubfoot is accompanied by the following symptoms :
Clubfoot in children - photo:
With clubfoot, the child gets used to placing his foot in a certain position . In the process of treating the disease, this habit must be eliminated.
If the child continues to walk in his usual manner, then it will be extremely difficult to correct his gait.
Treatment of clubfoot in children should be carried out comprehensively. With improper therapy or its absence, there is a risk of the baby developing disability .
The consequences of clubfoot in children can include the following conditions:
Recommendations for the treatment of hip dislocation in newborns can be found on our website.
The first procedure for diagnosing deviations in the formation of the musculoskeletal system in a child is carried out by specialists at the stage of its intrauterine development .
A screening test helps identify pathology.
The second stage of diagnosis is carried out immediately after the birth of the baby. The doctor examines the baby's feet and performs special visual tests. In some cases, clubfoot becomes noticeable after the child learns to walk independently .
Methods for diagnosing clubfoot include the following procedures:
There are several main ways to treat clubfoot in children. The choice of a particular method depends on the degree of progression of the pathology .
If it is not possible to correct the incorrect position of the baby’s feet using conservative procedures, then the only way to solve the problem is surgical intervention.
If clubfoot is detected after the baby is born, then in most cases the method of casting the limbs (the bones of a newborn have a soft structure and can be easily adjusted).
Massage is an integral part of the treatment of clubfoot in children.
For the first month, this procedure should be carried out by a qualified specialist .
In the future, the technique can be repeated at home, but first you must observe how a professional performs it.
Before the procedure, it is necessary to warm up and relax the child’s leg muscles. Only after this the main massage .
Massage technique for clubfoot in children:
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to start performing special gymnastics aimed at treating clubfoot from the age of three weeks .
When performing exercises, it is important not to cause pain to the child and to control your actions.
During gymnastics, you can interest the baby with a rhyme, song or funny music. Doctors recommend continuing to do the exercises not only until clubfoot is completely eliminated, but also to prevent the disease .
A set of exercises for clubfoot in a child:
Children with clubfoot are recommended to wear special orthopedic shoes .
You can purchase it in specialized stores.
To correct the position of a baby’s foot, a special shoe model has been created - braces .
Visually, it resembles boots attached to a metal or plastic plate at a certain angle.
You will have to wear the braces almost twenty-four hours a day, removing them only when sleeping or bathing.
For clubfoot, orthopedic shoes should have the following elements :
Surgery is used to treat severe clubfoot .
The surgical procedure may be aimed at lengthening the tendons, correcting the skeleton of the foot , or additionally eliminating the factors that triggered the disease (for example, a tumor located on the child’s foot).
The operation is prescribed for children who have reached the age of four years. Indications for surgical intervention are the following factors:
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Dr. Komarovsky draws the attention of parents to the fact that clubfoot cannot be eliminated without special treatment measures .
It is much more difficult to cure an advanced form of this disease than a pathology identified in the early stages.
In addition to the procedures carried out in medical institutions, it is necessary to additionally work with the child at home . Learning basic massage or therapeutic exercises is not difficult even for those who have never practiced these techniques.
Based on the opinion of Dr. Komarovsky, the following conclusions can be drawn:
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Preventive measures to prevent clubfoot in a child should be carried out at the stage of its intrauterine development .
Women are advised to completely give up bad habits, follow a proper diet and regularly monitor the condition of the fetus in medical institutions.
If signs of clubfoot have not been identified in a newborn, then in the first years of his life it is necessary to prevent the acquired pathology.
Prevention measures include the following recommendations:
You can confirm the diagnosis of acquired clubfoot in a child before going to the doctor. The baby must take a few steps on the wet sand.
The pathology of the foot will be clearly visible from the footprints . If the diagnosis of congenital clubfoot was made to the baby almost immediately after his birth, then the treatment process must begin as early as possible.
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How to correct clubfoot in a child? You can learn about the treatment of congenital clubfoot
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Disability is a person's condition with the inability to perform mental, physical or mental activities. The procedure for establishing disability in the Russian Federation is carried out by the relevant authorities, and at the same time carries medical and legal significance. Determination of disability gives the right to receive a number of benefits and pension payments, despite the fact that a person who has received a certain degree of disability cannot work partially or fully. In modern society, the concept of “disabled person” is considered to be the more correct term “person with disabilities.”
Disability status is determined by several groups:
At the same time, there is an opinion among Russians that there is a list of diseases, according to which a certain disability status can be obtained. However, not all diseases listed on this list qualify for disability. So, for example, a person with cancer, after completing all courses of long-term rehabilitation therapy, may be sent for examination to obtain the status of a disabled person of a certain degree, and the commission will decide the issue of either extending sick leave without establishing a disability group, or determining the status of a disabled person 2nd group for a period of one year, after which, after re-examination, the disability is removed or extended again. It is believed that the duration of continuous sick leave should not exceed 4 months, with breaks - 6 months.
There is a list of persons who have the right to receive disability on an indefinite basis, which includes:
In addition, there is a list of diseases for permanent disability, which include:
The conditions for establishing disability are determined by the criteria and classification regulated by Order of the Ministry of Health and Social Development of the Russian Federation No. 1013n dated December 23, 2009 “On approval of classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination.” (see below)
Order of the Ministry of Health and Social Development of the Russian Federation dated December 23, 2009 N 1013n “On approval of classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination”
and social development
dated December 23, 2009 N 1013n
On approval of classifications and criteria used in the implementation of medical and social examination of citizens by Federal state institutions of medical and social examination
In accordance with subclause 5.2.100.32 of the Regulations on the Ministry of Health and Social Development of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 30, 2004 N 321 (Collected Legislation of the Russian Federation, 2004, N 28, Art. 2898; 2005, N 2, Art. 162; 2006, N 19, Art. 2080; 2008, N 11, Art. 1036; N 15, Art. 1555; N 23, Art. 2713; N 42, Art. 4825; N 46, Art. 5337; N 48, Art. 5618; 2009, N 3, Art. 378; N 2, Art. 244; N 6, Art. 738; N 12, Art. 1427, 1434; N 33, Art. 4083, 4088), I order :
1. Approve the classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination, according to the appendix.
2. Recognize as invalid the Order of the Ministry of Health and Social Development of the Russian Federation of August 22, 2005 N 535 “On approval of classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination” (registered by the Ministry of Justice of the Russian Federation September 13, 2005 N 6998).
and social development
dated December 23, 2009 N 1013n
CLASSIFICATIONS AND CRITERIA,
USED IN CARRYING OUT MEDICAL AND SOCIAL EXAMINATION
CITIZENS BY FEDERAL STATE INSTITUTIONS
I. General provisions
1. The classifications used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination determine the main types of dysfunctions of the human body caused by diseases, consequences of injuries or defects, and the degree of their severity; the main categories of human life and the severity of the limitations of these categories.
2. The criteria used when carrying out medical and social examination of citizens by federal state institutions of medical and social examination determine the conditions for establishing disability groups (category “disabled child”).
II. Classifications of the main types of dysfunctions
organism and the degree of their expression
3. The main types of dysfunctions of the human body include:
disturbances of mental functions (perception, attention, memory, thinking, intelligence, emotions, will, consciousness, behavior, psychomotor functions);
disorders of language and speech functions (oral (rhinolalia, dysarthria, stuttering, alalia, aphasia) and written (dysgraphia, dyslexia), verbal and non-verbal speech, voice formation disorders, etc.);
disorders of sensory functions (vision, hearing, smell, touch, tactile, pain, temperature and other types of sensitivity);
violations of static-dynamic functions (motor functions of the head, torso, limbs, statics, coordination of movements);
dysfunctions of blood circulation, respiration, digestion, excretion, hematopoiesis, metabolism and energy, internal secretion, immunity;
disorders caused by physical deformity (deformations of the face, head, torso, limbs, leading to external deformity, abnormal openings of the digestive, urinary, respiratory tracts, disturbance of body size).
4. In a comprehensive assessment of various indicators characterizing persistent dysfunctions of the human body, four degrees of their severity are distinguished:
III. Classifications of the main categories of life activity
person and the severity of the limitations of these categories
5. The main categories of human life include:
6. In a comprehensive assessment of various indicators characterizing the limitations of the main categories of human life, 3 degrees of their severity are distinguished:
a) ability for self-care - a person’s ability to independently fulfill basic physiological needs, perform daily household activities, including personal hygiene skills:
b) the ability to move independently - the ability to independently move in space, maintain body balance when moving, at rest and when changing body position, to use public transport:
c) orientation ability - the ability to adequately perceive the environment, assess the situation, the ability to determine the time and location:
d) ability to communicate - the ability to establish contacts between people by perceiving, processing and transmitting information:
e) the ability to control one’s behavior - the ability to self-awareness and adequate behavior taking into account social, legal, moral and ethical standards:
f) learning ability - the ability to perceive, remember, assimilate and reproduce knowledge (general education, professional, etc.), mastery of skills and abilities (professional, social, cultural, everyday):
g) ability to work - the ability to carry out work activities in accordance with the requirements for the content, volume, quality and conditions of work:
7. The degree of limitation of the main categories of human life activity is determined based on an assessment of their deviation from the norm corresponding to a certain period (age) of human biological development.
IV. Criteria for establishing disability groups
8. The criterion for determining the first group of disability is a person’s health impairment with a persistent, significant disorder of body functions, caused by diseases, consequences of injuries or defects, leading to limitation of one of the following categories of life activity or a combination of them and necessitating his social protection:
9. The criterion for establishing the second group of disability is a person’s health impairment with a persistent severe disorder of body functions, caused by diseases, consequences of injuries or defects, leading to limitation of one of the following categories of life activity or a combination of them and necessitating his social protection:
10. The criterion for determining the third group of disability is a person’s health impairment with a persistent moderately severe disorder of body functions, caused by diseases, consequences of injuries or defects, leading to a limitation of the ability to work of the first degree or a limitation of the following categories of life activity in their various combinations and necessitating it social protection:
11. The category “disabled child” is determined if there are limitations in life activity of any category and any of the three degrees of severity (which are assessed in accordance with the age norm), causing the need for social protection.