Equinus
Dr. med. Julia Schwarz is a freelance writer in the medical department.
More about the experts All content is checked by medical journalists.An equinus foot is another misalignment of the foot in which a raised heel is in the foreground. The heel cannot touch the ground when walking. Those affected literally walk on “tiptoe”. The equinus can be congenital or acquired. Small children and bedridden elderly people are mostly affected. There are various conservative and surgical options for treating the deformity. Read more about equinus here.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. M21Q66
Equinus foot - orthopedic problems
The equinus foot (pes equinus = horse's foot) is characterized by the fact that the heel cannot touch the ground when standing. The medical name comes from the fact that horses also only walk on their toes, more precisely on the middle toe, which corresponds to the hoof. Walking toes is a major problem for people because the entire body weight then rests on the front part of the foot. The foot does not roll when walking. The result is an unstable stance and an incorrect load for which the feet are anatomically not prepared.
Equinus - Congenital or Acquired?
The equinus can be congenital or acquired.
A congenital equinus is usually based on a malformation. Either the lower leg bones or the Achilles tendon are not sufficiently developed or the unborn child was forced to posture in the womb.
Most of the time, however, the equinus is acquired, which means that it does not develop until after birth. Various diseases can affect the nervous system and thus cause an insufficient supply of the foot muscles, which are needed to roll the foot. If the nerve that supplies the large calf muscle (peroneau nerve) is damaged, equinus foot also occurs.
Disorders that affect the nervous system can also cause paralysis. For example, hemiplegia often occurs after a stroke, which can cause equinus foot. Cerebral palsy, which occurs, for example, as a result of trauma or a lack of oxygen during childbirth, can also be the cause of the foot deformity.
In addition, other diseases can trigger equinus foot. An example is hemophilia, in which blood clotting is delayed. If there is bleeding into the calf muscles, nerves can be squeezed, which can cause paralysis.
In the event of an accident or traumatic injury, nerves running through the calf muscles can be injured. This, as well as damage to the ankle joint or the muscles of the foot, can lead to an equinus foot.
Older patients in particular, who have been bedridden for a long time, no longer put enough weight on their feet. This leads to a shortening of the Achilles tendon. The duvet pushes the toes and the back of the foot slightly forward and strengthens the posture.
In addition, some children get used to walking on their toes, but this usually disappears on its own as they grow up.
Equinus foot - the diagnosis
The equinus can often be diagnosed with the naked eye. A muscle examination (electromyography), in which the electrical voltage is measured, helps to identify muscular causes of the equinus. An X-ray examination shows how much the bony structures are involved in the deformity. The knee and hip joints should also be x-rayed if necessary. You may already be affected by the equinus position.
Equinus foot - this is how it is treated
In general, any form of equinus is treated. However, if there is a one-sided leg shortening, this must not be corrected.
Which treatment is most suitable in each individual case depends on the severity of the deformity, the cause and the symptoms. Conservative and surgical treatment methods are available:
The non-invasive (conservative) treatment consists primarily of physiotherapy. An attempt is made to relieve the equinus foot through active and passive stretching in the lower leg and to bring the foot into its normal position. If physiotherapy is not sufficient as a treatment, a lower leg standing cast is applied. This plaster cast leads the equinus foot back to its original position over a long period of time and in stages.
If the conservative methods do not bring the desired success, a surgical intervention is necessary. The Achilles tendon is lengthened under anesthesia. Following the operation, a plaster cast is applied for stabilization for about four weeks. It is then recommended to put on a night splint to counteract regression. This method of treatment is particularly successful in children.
In adults who suffer from equinus foot, surgical joint stiffening (arthrodesis) can also be considered. This stiffens the upper ankle. The mobility of the lower ankle is retained, which means that the foot remains mobile. However, this surgical measure should only be used when the articular cartilage has already been severely worn away by the equinus.
If the results of the above therapies are insufficient, the equinus foot must be balanced with orthopedic shoe insoles. A wedge-like insert is placed in the shoe to enable normal gait.
Equinus foot - chances of recovery
Children who have got used to walking on the front part of the foot have a good prognosis: As they get older and heavier, walking on tiptoe becomes more and more difficult and they usually get used to it on their own.
If the equinus foot is caused by nerve damage or paralysis, on the other hand, intensive physiotherapeutic treatment is required to prevent consequential damage to the knee, hip and spine caused by the crooked gait. However, the equinus can usually not be completely cured.
Prevent equinus
One can actively prevent an equinus foot. If you are bedridden for a long time, you can attach a footboard to the bed, on which the feet are supported, in order to prevent the equinus position. In addition, regular stretching exercises for the calf muscles prevent an equinus foot.
Tags: pregnancy menopause Diagnosis
