ПЛОСКОТО ХОДИЛО -ПРИЧИНА И СЛЕДСТВИЕ
THE FLAT FOOT -CAUSES AND CONSEQUENCES

Summary/Abstract: The ankle and foot complex is small in volume and is the most distally located part of the human body. Due to its dual function – to ensure support and motion, it is necessary to possess a complex combination of flexibility and stability. Anatomically, the ankle and foot complex is characterized by a special form – dome-shaped. This is due to the specifics of the bones which build it, it is strengthened by multiple ligaments and is dynamically secured by muscles located on the foot and lower leg. The ankle/foot complex includes 26 bones, 33 joints and more than 100 muscles and tendons. At each step, the stress on the arch of the foot is equal to a fivefold increase of the own weight. This tension is different when standing, walking, jumping and running. Until the age of five, the joint-ligament system physiologically is not consolidated. It is believed that the arches of the foot are formed at the age of 6-8 years, i.e. at this age the presence of a flat foot is not considered a pathology. With a flat foot, the weight center changes, thus leading to improper distribution of the muscle strength in order to maintain posture and gait. As a result, degenerative changes occur in the joints of the lower limb, even in the spine. The flat foot (pes planus) is a normal condition in babies and young children, because normally a person is born without a foot arch. It is formed later, and in some children this can happen even at the age of 7, rarely until the age of 10. The greatest risk of developing а flat fооt and permanent damage of the feet is with overweight children. Children's feet are not fully developed until they are 14 to 15 years old for girls and 15 to 17 years for boys, which means that during this time, the bones of their feet are very plastic and can be easily damaged.The flat foot in children is divided into two types: a flexible flat foot - the foot is flat when stepping, however in a relaxed state a shaped arch is clearly visible and, a rigid flat foot – it occurs in much less cases and is due to bone adhesion. Then the foot is flat both during stepping and in a relaxed state, and an arch is not formed.Only in childhood it is possible to correct and recover the flat foot, because the weakness of the ligament system is subject to correction. At a later stage, however, the effect is unsatisfactory and the treatment is mostly symptomatic.

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