Introduction
A splayfoot is caused by incorrect loading of the foot. This can have many different causes. In order to better understand them, it is useful to understand the origin of the malposition: The normal foot is loaded in its front part at the 1st and 5th metatarsal head, while the other metatarsals form a dorsal arch when viewed in cross-section.
The second to fourth metatarsal head is practically in the air. This and the tarsal bones in connection with the ligamentous apparatus form the transverse arch of the normal foot. In contrast, the transverse arch of the forefoot disappears in the splayfoot.
As a result, the 2nd to 4th metatarsal bones receive an increased load. The main load on the foot is no longer borne by the pressure-accustomed points of the 1st and 5th metatarsal heads, but the pressure is borne by the pressure-unaccustomed points of the 2nd to 4th metatarsal heads. As a result, the forefoot of the splayfoot widens with the disappearance of the transverse arch.
The increased pressure on the 2nd to 4th metatarsal heads leads to an increased formation of calluses on the sole of the foot above the heads, which is very painful. Further consequences are that not only the metatarsal head, but the entire metatarsal bone sinks. The risk of metatarsal fractures increases, and the strain on the tarsal bones also increases.
In some cases, the splayfoot can lead to arthrosis in the tarsal joints. Due to this pain, the normal rolling mechanism of the foot is disturbed and the patient instinctively brings the foot into a slight internal rotation position (supination), i.e. he puts load on the outside of the foot, which causes the shoe to twist outwards and thus become crooked. The causes of splayfeet are different:
- Through long standing and walking without getting used to it,
- Due to rapid increase in body weight (obesity, pregnancy, etc.
)
- By certain professions with long standing on hard, smooth floors (e.g. cooks, salesmen, doctors)
- By carrying and lifting heavy loads. These overloading of the foot as listed under 1 a – d can be the cause for all types of foot lowering.
- Through innate disposition.
- By overloading the foot: by standing and walking for long periods of time without getting used to it, by rapidly increasing body weight (obesity, pregnancy, etc.) by certain professions with long periods of standing on hard, smooth floors (e.g. cooks, salesmen, doctors) by carrying and lifting heavy loads.
These overloading of the foot as listed under 1 a – d can be the cause for all types of foot lowering.
- Through long standing and walking without getting used to it,
- Due to rapid increase in body weight (obesity, pregnancy, etc. )
- By certain professions with long standing on hard, smooth floors (e.g. cooks, salesmen, doctors)
- By carrying and lifting heavy loads. These overloading of the foot as listed under 1 a – d can be the cause for all types of foot lowering.
- Through fashionable shoe variations; the splayfoot is much more common in women than in men due to the unnatural steepness of the foot in shoes with high heels.
On the other hand, the pointed toe cap of this type of footwear explains the toe malformations often found in splayfoot.
- By injuries; this can also include the so-called march fracture. In this case, the foot is overstressed for a long period of time, which causes it to sink into the ground, often resulting in a fracture or only in a collapse (infraction) of one, rarely several metatarsal bones. The name comes from the fact that the marching fracture was observed in untrained soldiers, especially in the military after long marches.
- Due to a weakness of the ligamentous apparatus that appeared later.
- Through paralysis.
- Through bone diseases.
