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Foot disorders

Usually take the form of abnormalities in the shape of the foot. These are often congenital, but can also arise in later years caused, for example, by shoes which are too tight. A club-foot is congenital. The foot is turned inwards and tilted, so that only the outer edge of the foot touches the ground. Club-feet occur in either or both feet in about 1 in 1000 new-born babies; boys have them twice as frequently as girls. Treatment must be commenced as soon as possible and consists of repeated applications of plaster to impose normal posture gradually. A surgical operation can be performed if necessary. A hollow foot has a characteristic strong upward curvature caused by a disturbance in the normal balance between various groups of muscles. Paralysis or weakness of certain muscles is often the cause; an operation is usually the only solution. In flat feet, the arch of the foot has fallen so that the whole sole of the foot touches the ground. Flat feet frequently occur in overweight people, pregnant women and workers in professions involving an abnormal amount of standing. Young children can suffer from flat feet by walking too early and too often. Symptoms include pain and fatigue in walking and standing. Back complaints also often occur. Treatment is by means of muscle exercises and arch supports. In addition to abnormalities of shape, fractures of one or more bones in the foot also occur as a result of injury or even walking for long distances. Foot ailments may be accompanied by back complaints caused by abnormalities in the walking pattern or by abnormalities which occur in standing. Inflammation of the foot joints is also common, as the result of a wound or part of a rheumatic disorder. Disturbances in the supply of blood to the foot, especially the toes, frequently occur in scleroderma, diabetes, or fatty degeneration of the arteries (atherosclerosis). Death of tissue occurs as a consequence. The dead tissue forms an ideal culture medium for bacteria, and wet necrosis or gangrene can be the result.

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