Foot deformity is a kind of abnormality or defect in the shape of the foot. It can be due to the joint, muscle, ligament, and bone of the foot region which affect the complete functioning of the foot. Over time foot deformity is known by other names such as “Clubfoot”, and “Congenital Talipes Equino Varus ( CTEV).
Equinus is described Foot deformity derived from ‘equine”,i.e., a horse who walks on toes): This is a deformity where the foot is fixed in plantar – flexion. This Foot deformity is often caused byย tightness in the Achilles tendon or calf muscles. The tightness can be due to any congenital ( present from birth ) and may be the result of the cast, crutches, or high heels.ย ย
Calcaneus foot deformity is the reverse of equinus where the foot remains fixed in the dorsiflexion position. According to an Abstract done by GW Bradley, S S Colmen says that calcaneus is a neural disorder and is due to the tightness of the triceps surae muscles.ย The other major cause of this foot deformity is typically congenital (present by birth), it can be due to forced posture in the womb.
ย Splay is a rare congenital deformity( rarely found inborn ). The transverse arch in the splay foot deformity is flattened making the front of the foot wider and resulting in more pressure on the middle bones of forefoot. Anatomically over-straining of metatarsal bone increases the distance between meta-tarsals making wider space between them. The cause of splay foot can be obesity, improper footwear (when footwear is too tight ), or high heels.
Cavus is also known asย High-arched feet. As the name suggests, A person suffering from this deformity has a longitudinal arch of the foot that is exaggerated. People with these Conditions, such as cerebral palsy, Charcot-Marie-Tooth disease, spina bifida, polio, muscular dystrophy or stroke, and other neurological conditions are more likely to have cavus.ย
Planus is also denoted as flat foot deformity where the longitudinal arch is flattened. The hollow arch which is present below the foot is flatter. Many people when they stand the whole sole of the foot touches the ground. People are rarely born with it, they usually develop over time.
Varus foot is inverted and adducted at the mid-tarsal joints so that the sole ‘faces’ inwards.ย
Valgus is the reverse of varus where the foot is everted and abduction at the mid-tarsal joints so that the sole ‘faces’ outwards.
1. Pressure on other structures leads to pain
2. The skin becomes hard and thick, leading to calluses formation.
3. The weakening of foot muscles. Increased use of this muscle can make them fatigue easily.ย
4. Abnormal strain on the foot.
5. Joint inflammations ( pain and redness are common ).
6. High-arched feet are often caused by nerve problems.
7.ย Foot deformity affects the way you walk and gait pattern changes.ย
In the vast majority of cases, aetiology is not known, hence it is termed idiopathic. In others,
the so called secondary clubfoot, some underlying cause such as arthrogryposis multiplex congenital
(AMC) can be found.
Idiopathic clubfoot: Following are some of the theories proposed for the aetiology of idiopathic clubfoot:
a) Mechanical theory: The raised intrauterine pressure forces the foot against the wall of the uterus in the position of the deformity.
b) Ischaemic theory: Ischaemia of the calf muscles during intrauterine life, due to some unknown factor, results in contractures, leading to foot deformities.
c) Genetic theory: Some genetically related disturbances in the development of the foot
have been held responsible for the deformity.
Secondary clubfoot: The following are some of the causes of secondary clubfoot:
a) Paralytic disorders: In a case where there is a muscle imbalance i.e., the invertors and plantar flexors are stronger than the evertors and dorsiflexion, an equino-varus deformity will develop. This occurs in paralytic disorders such as polio, spina bifida, myelodysplasia and Friedrichโs ataxia.
b) Arthrogryposis multiplex congenita (AMC):
This is a disorder of defective development of the muscles. The muscles are fibrotic and result in foot deformities, and deformities at other joints.
Treatment of the calcaneocavus foot deformity. PubMed –https://pubmed.ncbi.nlm.nih.gov/72
Essential ORTHOPAEDICS . Based on educational curriculum of NMC. Maheshwari & Mhaskar
Dr Ignacio Ponseti, Congenital Clubfoot. Fundamentals of Treatment(Oxford University Press),ย 1996.Theย bookย (also known as theย Green Ponseti Book.ย ย
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