Transverse arch

TRANSVERSE ARCH

Deformations of transversal arch, being one of bearing supporting arches, are often observed in the very early age, practically about 3 years old. Presence of these deformations constitutes not just movement limitations but it means as well distortion of functioning for the mightiest muscles group – venous pump delivering blood to the heart. The heart failure, the development of diabetic angiopathy must be considered exactly through this connection.

Inside the transversal arch, joint heads of metatarsal bones for second and third toes are located above bearing support platitude. These two joint heads represent the arch vertex, and through them axis of loading passes. The joint heads of first and fifth metatarsal bones are arch support points, under which fat intercalation is placed (provides pressure distributed evenly on the joint).

Transversal flatfoot is developed under the shifting of loading to the side of big toe or little toe. It happens in the following cases: when the person’s gait (walking, pace) is not correct, while feet are disposed with toes positioned outwards, when person is overweight, or if tight footware with high heelpieces and narrow toes-section is used.

Inside orthopaedic practise the opinion was established, that transversal arch deformations (as well as other types of deformations) are unimprovable and remediless. More often than not surgical intrusion is recommended. But there is no say that it leads to disability, to limitation in feet functioning, therefore to defection in human organism functioning.

The photo images show the stages of deformations development for transversal arch. Examining into these stages is needed for understanding how exactly and in what reverse sequence it is reasonable to perform arch reconstruction and rehabilitation. Nowadays all these drawbacks is possible to normalize, or to provide comfort to the feet in any condition. Principal requirement at the moment all efforts are directed to rebuilding of muscles pump function and forces balance in the complex of “diverting” and “inverting” muscles. If the orthopaedic specialist does not possess knowledge on kinematic of conjugation and loading in skeletal-muscles structures, he would not be able to fulfill this work.

1. First stage of deformation represents descending of joint heads for 2-3rd and 4th metatarsal bones, that form the corresponding toes joints. While descending, 2nd and 3rd metatarsal bones at first come closer, squeezing and traumatizing tissues, vessels, nerve fibres between them, and immediately afterwards these bones begin to draw apart and outside the joints of 1st and 5th toes. The joint heads are couched completely on support surfaces of footware orthotics causing the soles burning sensation, toes numbness, pain.

2. Second deformation stage shows us allegedly the curvature of big toe outwards – Hallus-Valgus. But in reality the big toe position is the result of staving outside for 1st and 5th joints. Phalanx of first and fifth toes retain their standard previous place, they are restrained by inverting muscles. The larger is joints shifting, the more substantial become the “angle of curvature” for them. It is clearly seen on the X-ray image. But for some reason, nobody pays attention at fracture of short cuboid muscles (3) as well as ligaments in shallop-shaped metatarsal joint (4). In addition, the already formed gap is step by step filled in with bone tissue. Precisely this is main reason for serious difficulty in foot rehabilitation.

3. Next stage constitutes that as the result of arch widening the big toe joint is moving outwards yet farther, and inverting muscle of big toe pulls the toe strongly towards second toe. Big toe begins to displace and extrude second toe upwards, and soon third and fourth toe follow. If the person walks with toes turned outwards and uses footware with tight toe-section, it contributes to deformation of toes displacement. Two forces – inertia force and reaction of support base force accelerate the process of big toe turning. All other toes follow through the same process. They begin to contort and twist, taking shape of hammer (hammer-shaped toes).

4. At time of fourth stage loading of 2nd and 3rd joints abruptly increases. This causes forming of calluses or corns stems, as well as tissue tearing and bone egressing over the footsole limits. All these stages are marked with defection in gait’s biomechanics, absence of final step phase, strong push. The mightiest “gostrocnemius” muscles (back part of lower leg) are not contracted, therefore venous-muscles pump does not work effectively. And if toes are turned outwards, functioning of ankle joint is blocked, atrophy of gostrocnemius muscles begins.