Kink Foot: Causes, Symptoms & Treatment

Knee foot is a congenital or acquired deformity of the foot. The affected foot lowers at the medial inner edge of the foot and raises at the lateral outer edge. Foot gymnastics is usually used for correction.

What is a bent foot?

Deformities of the foot can be congenital and acquired, such as flatfoot. From these malpositions, other foot malpositions can develop again over time. One of these is the so-called bent foot. This is a deformity in which the medial inner edge of the foot lowers while the lateral outer edge rises. In young children, this is considered a physiological stage of development and is therefore not associated with any disease value. Adults with a bent foot can, but do not have to suffer from the deformity. A bent foot can develop into bow legs or knock knees, for example. Other secondary diseases and pain are also conceivable. Basically, every type of bent foot affects the statics of the body. Nevertheless, the deformity does not necessarily have to be treated if the patient decides against therapeutic intervention despite an awareness of the possible consequences. Not only among humans, but also in the animal kingdom, the bent foot or pes valgus is common. Large dog breeds, for example, often suffer from the phenomenon. In most cases, a growth disorder of the lower fibular epiphyseal joint is responsible. The bent foot can be associated with a flat or flat foot.

Causes

Between eight and ten years of age, a child’s foot strengthens to the point where the foot barely bends inward. If this is not the case, a pathological bent foot is present. Bending feet can not only be acquired in the course of life, but can also be congenital. In most cases, acquired bent feet develop from a congenital or acquired flat foot, after trauma to the foot bones, spastic paresis of the foot, or as a result of an infection. Rheumatism, overuse damage with ligament instability or obesity can also contribute to the development of a bent foot. In the case of a bent foot, the ankle bone is pressed downwards and shifts medially, so that the heel bone is in pronation position. The image of a double ankle is created because the ankle bone clearly protrudes under the ankle. Due to the altered position of the ankle bone in the ankle fork, the foot positions itself obliquely against the lower leg, with the inner edge of the foot lowering. Apart from this process of development, the bent foot can be the symptom of a congenital deformity or even malformation syndrome.

Symptoms, complaints and signs

Subjectively, patients with a bent foot often have no complaints. Pain is uncommon and occurs mainly, if at all, in the area of the medial malleolus or medial longitudinal arch. This is especially true for patients who suffer from both a bent foot and a lowered foot at the same time. The ankle pain may extend down the side of the leg in later stages, radiating to the hip. Since the inner ankle protrudes strongly in the case of a bent foot, the lower ankle joint shifts and the heel bone deviates towards the outside. Only in extremely rare cases do pronounced bent feet cause pain in the outer ankle due to a collision with the calcaneus. The statics of the body are always affected by a bent foot. In most cases, however, patients with a congenital bent foot in particular are not even aware of this impairment. Only when knee complaints, bow legs or knock knees arise from the bent foot, many affected people seek a doctor.

Diagnosis and course of the disease

The doctor looks at the patient standing barefoot to diagnose the bent foot. From behind, the patient in this position shows an angle of about five degrees between the axis of the lower leg and the heel. In the case of a bent foot, this angle is significantly increased. The varus position of the heel is often reduced in the toe stand. Under certain circumstances, the sole of the foot may show calluses on the medial heel. Confirmation of the diagnosis can be provided by imaging techniques. X-rays show increased eversion in the area of the subtalar joint. However, even without the detectability of such an eversion, a bent foot may be present, so radiography is often omitted.

Complications

A bent foot does not necessarily result in particular complaints, limitations, or complications in every case.In many cases, sufferers with a bent foot can lead an ordinary life. However, pain can still develop in the ankles and spread to other regions of the leg or even to the hip. Likewise, the patient’s movement may be restricted as a result of the bent foot. The patient’s sense of balance and coordination are also significantly impaired by this disease. If the bent foot already occurs in childhood, crossed legs may continue to occur in adulthood. At the same time, many patients also suffer from aesthetic complaints. Especially in children, the bent foot can lead to teasing or bullying. In this case, treatment is only necessary if the affected person suffers from discomfort. Various therapies or interventions can correct the deformity. Furthermore, psychological treatment may also be necessary. Life expectancy is usually not reduced by the bent foot.

When should you go to the doctor?

Kink foot does not need to be treated by a doctor in every case. Often, patients with a bent foot can live a normal life without experiencing pain or other problems. A visit to the doctor is necessary if the bent foot causes discomfort. For example, pain, malpositions or signs of joint wear must be medically clarified and treated. Medical advice is also required if the bent foot significantly impairs the quality of life. Furthermore, with a bent foot that is based on a serious disease, regular visits to a doctor should be made. For example, rheumatism and obesity patients must have close consultation with the appropriate medical professional. If the ankle pain intensifies and radiates down the leg or even to the hip, medical advice is necessary. Knee pain, bow or knock knees, and joint conditions are other reasons to see a doctor with the bent foot. The family doctor can establish contact with an orthopedist or rheumatologist. If the symptoms are severe, the emergency medical service or the nearest hospital should be contacted quickly.

Treatment and therapy

In most cases, bent feet do not require further therapy. This is especially true if the patient does not subjectively notice any discomfort. However, if pain, knee discomfort or even bow or knock-knees become apparent, further development can be countered with treatment. As a rule, insoles are sufficient as a treatment measure. Only in extremely rare cases does surgery take place. This applies, for example, if the posterior tibialis muscle and its tendon are unstable. In this case, a tendon transfer may be arranged in combination with a calcaneal osteotomy. Invasive treatment must be carefully assessed by the physician in advance for its benefits and risks to the patient. If the risks exceed the benefits, foot gymnastics are more likely to be prescribed instead of surgery. In the gymnastic sessions, usually at least an improvement of the symptoms can be achieved, as the muscles and tendons become more stable through the movement. If knee deformities are already present, a high tibial osteotomy or supracondylar femoral osteotomy may be performed to correct them. If the deformities have impacted the spine, attendance at a back school is advised.

Outlook and prognosis

In most patients, the prognosis is favorable. Often, no other complaints are present, so the visual change has no medical value from a medical point of view. Therefore, no treatment measures are taken in these cases. The quality of life is not further impaired and a shortening of the life span is also not given by the disorder. If physical impairments are present, individual treatment steps are initiated. Depending on the extent of the symptoms, a treatment plan is drawn up. This can be based on conservative methods or include surgical intervention. The goal is to improve the range of motion. Normally, the desired improvements are achieved if the patient adheres to the guidelines and no further complications occur. Nevertheless, when making a prognosis, it must be taken into account that every operation is associated with risks and side effects. In rare cases, additional emotional and psychological distress occurs due to the visual changes.Although there are no physical complaints due to the bent foot, the stresses can have a negative effect on the patient’s overall condition. There is a risk that psychological sequelae will develop and manifest. These lead to a worsening of the prognosis, as they are usually protracted and have a strong negative impact on the well-being of the affected person. Anxiety disorders or attachment problems may develop, resulting in impaired lifestyle.

Prevention

If a young child still has a foot deformity when he or she reaches the age of seven, a permanent bent foot can be prevented with measures such as foot gymnastics. In addition, walking barefoot on uneven surfaces can stabilize the unstable foot.

Aftercare

Children and adolescents who are affected by a foot deformity – such as the bent foot – should be permanently cared for by a specialist. This specialist can document the course and provide a prognosis for further development. This is particularly important during the growth phase. The specialist, in most cases an orthopedist, will also decide on the necessity of surgical intervention and provide ongoing medical care for those affected. If an operation has been performed on the foot, it is advisable to continue to see the orthopedist once a year for a check-up. In addition, the wearing of orthopedic shoes or insoles is usually necessary. In some cases, it is necessary to make a custom-made shoe. Their accuracy of fit can also be confirmed by a specialist. He or she can also give advice on the choice of specialist store. Furthermore, physiotherapy and the application of ointments can be prescribed. In physiotherapy, foot exercises are taught, which the patient should also use regularly at home. Due to improved surgical methods, which are now minimally invasive, follow-up periods have shortened considerably. As a rule, walking without support is possible after only eight weeks. Any signs of paralysis or other sensory disturbances that may occur vary from patient to patient. Their intensity prolongs or shortens the duration of aftercare and determines the support methods chosen. Affected individuals should not resume sports until at least four months have passed.

Here’s what you can do yourself

In many cases, a bent foot does not need to be treated. Treatment is only necessary when the patient experiences pain and other discomfort. Medical therapy can be supported by the patient by taking it easy on the affected foot. Accompanying this, the doctor’s instructions should be followed. In most cases, it is sufficient to wear the prescribed insoles and otherwise not to put any further strain on the foot. This should be accompanied by regular checks by the doctor. This ensures that the bent foot does not become worse and that no complications occur. If surgery is necessary, further self-help measures should be avoided. It is indicated to follow the doctor’s advice and not to put unnecessary stress on the foot or tendons. After surgery, the surgical wound must be carefully cared for to avoid bleeding, infection and other postoperative complications. However, if any discomfort should occur, a doctor should be consulted. Acute pain, problems with movement or signs of paralysis are best dealt with immediately by speaking to the appropriate medical professional. After treatment, light stretching exercises and athletic measures can be started in consultation with the physician to support the healing process.