Short flexors of the toes

The muscular anatomy of the human foot is such that the dorsum contains the short flexor muscles and the long flexor tendons, which originate from the tibia.

The musculature of the lower leg and foot

Although this part of the leg has the smallest volume, there is a large amount of muscle. The main muscles of the lower leg and foot are responsible for a large amount of movement when man moves through space.

Due to the coordinated work of the muscles of the lower limbs, walking, running and jumping movements are performed. The lower leg muscles are responsible for flexing and extending the foot, activating the articulation mechanism and enabling the stride.

The complex anatomy of the lower leg and foot muscles has a lot to do with the long evolution of humans. The ability to grasp with the toes has been lost, but the musculature to do so has survived in rudimentary form throughout life.

The numerous longitudinal, transverse and oblique muscles of the human foot allow ballerinas to dance on tiptoe and effectively correct flat and club feet when sufficiently developed.

General information about the muscles of the lower leg

The anatomy of the muscles of the lower limbs is such that they mainly act on the ankle, flexing and extending the foot; in addition, they act on the toe joints and bend the knee joint.

Since the feet are the bearing surfaces of the entire body, the positioning of the feet (and therefore the entire body) in relation to the ankles is the most important movement in all movement and in maintaining an upright body position.

It is very important to keep the lower limbs in an upright position. In the one-legged stance phase, the tibia is only supported by the tibia in the knee joint.

All muscles of the lower limbs are involved in this function. The overall muscular structure of the lower limbs allows for successful balance and rhythmic movements. This is general information, but now let's get into the details.

There are three muscle groups in the lower leg: Posterior - Muscles that flex the foot and toes; Anterior - Muscles that extend the foot and toes; Lateral - Muscles that pronate and flex the foot.

Posterior muscles of the lower limbs: They are used in walking (and other forms of locomotion: running and jumping) to push the body off the ground.

This movement is achieved by flexing the ankle and flexing the metatarsophalangeal joints. Therefore, the hamstrings are the strongest, of which the triceps are the strongest.

The triceps tibialis muscle (m.triceps surae) lies superficially and gives a round shape to the proximal part of the tibia.

Its two heads form the calf muscle (m. gastrocnemius), and the third underlying muscle is called the lambda muscle (m. soleus).

CLAW DEFORMITY

The claw-shaped deformity is the result of an imbalance between the external and internal muscles of the foot, leading to flexion of the PMFS and extension of the PFS. The TMPS rises up and begins to make constant contact with the shoe, causing a painful blister at that point (Fig. 1).

claw toe. The deformity of the second toe is the most obvious, but in this case all the little toes are deformed.

If only one finger is deformed, it is usually due to trauma or an inflammatory disease. More commonly, however, all four little fingers are deformed and the cause is a congenital muscle imbalance (external muscles > internal muscles) or nerve damage (neuropathy).

Claw deformity of the fingers can be congenital or acquired and occurs at any age, but is slightly more common in the elderly and old (70-80 years). It occurs 4-5 times more often in women than in men.

HAMMER TOE AND HAMMER TOE DEFORMITIES

Hammer toe is most commonly caused by wearing tight shoes that constantly flex the toe. This deformity also occurs in patients with a valgus deformity of the first toe.

Hammer toe deformity (ie, isolated DMFS flexion) can result from compression of the toe in shoes (and gradual thinning of the extensor tendon). This deformity can also be caused by an overstretching of the finger flexor tendon (flexor longus I).

SYMPTOMS AND DIAGNOSIS OF THE DISEASE

Patients with little finger deformities are usually elderly women who complain of pain in the back of the fingers (where they are in constant contact with footwear). Patients may also complain of toe pain caused by constant rubbing on the soles of shoes. With long-term deformities, painful corns can form on the sole surface at the base of the toes.

The deformity is usually visible externally, and x-rays can confirm the clinical finding.

During the physical examination, the condition of each toe joint should be assessed to determine whether passive correction of the deformity is possible, that is, whether the deformity is flexible or rigid (treatment tactics depend on this).

Any deformity of the little toes should lead the doctor to suspect that the patient has diabetes or a neurological condition that may be the primary cause of the deformity. It is therefore essential to examine these patients as closely as possible.

Since small toe deformities are often a symptom of a neurological condition, a thorough assessment of foot sensitivity and muscle strength is required.

TREATMENT OF LITTLE TOE DEFORMITIES

3 symptoms

People dealing with hammer toenotice changes in the appearance of the toe. It is characterized by a firm flexion of the toe and a depression at the tip of the toe, which makes it difficult to wear closed shoes. That should be noted. It is stiff and causes painful discomfort.

Initially, the toe is functional and flexible, and the changes are reversible. Over time, however, he becomes, among other things. increasingly stiff and permanent. Hammer toe is often accompanied by the symptom of a valgus deformity of the big toe.

People who neglect this problemA painful contracture develops. Dislocation of the metatarsophalangeal joint of the big toe can also occur, which significantly impairs normal walking.

4. Treatment

A distinction is made between conservative and surgical treatment of the hammer toe.

4.1 Conservative treatment
In the early stages of the disease, wearing appropriate footwear (flat-soled shoes) may be sufficient. It is very important to avoid shoes with a pointed toe as this greatly contributes to aggravating the deformity. In case of a painful bunion special toe protectors can be used to reduce friction and protect the painful area. Also, you should special orthopedic insoles buy with a metatarsal pad, which should relieve the head of the metatarsal bone.

Another method of conservative treatment is exercisesaimed at improving mobility of the shortened toe and reducing contracture of the flexor and extensor tendons of the affected toe. However, it should be noted that in some people The deformities progress very quickly. In this case, surgery is the only option.

4.2 Surgical treatment
Surgical treatment includes:
Pisani operation (on the flexor tendon of the short finger);
Girdleston operation (at the flexor tendon of the long finger).
After the operation, those affected must wear special footwear for 5 weeks. After that, normal shoes can be used.. Just make sure they have a flat sole and a toe box that isn't too tight. Full movement is not recommended only 3 months after the operation. In order to return to normal functioning as soon as possible, it is advisable to visit a qualified physiotherapist who will select individual exercises and offer appropriate treatment.

1.3 Postoperative Complications:

triggering factors

The progression of a disease such as claw toe deformity is often accompanied by the development of other foot pathologies related to muscular imbalance.

The following factors can trigger the disease:

• inflammation of the joint structures;
• Uncomfortable footwear (constricting, stiff, high heels);
• Anatomical features of the ankle;
• Genetics;
• Various types of foot injuries;
• Neurological diseases that contribute to the development of muscle dysfunction;
• Poliomyelitis;
• high arch.

Due to the natural decline in the functional activity of the musculoskeletal system, the susceptibility to pathologies in elderly patients is increased. If necessary, our clinic offers comprehensive treatment of the spine and joints.

therapeutic program

In the early stages of the disease, conservative methods of treatment are used. Surgery is indicated for fixed deformities and irreversible changes.

conservative methods

The goal of conservative treatment of toe deformity is to reduce pain and slow the progression of the disease. First of all, the patient is advised to choose comfortable shoes.

In addition, the following techniques are used:

1. Use of orthotics, insoles to immobilize the toes and avoid pressure on the forefoot.
2. Taping (reduces joint stress and immobilizes flexed toes parallel to sole surface).
3. physical exercises. They promote the straightening of the toes and their correct alignment.

If the pathology progresses and the prognosis is unfavorable, surgical treatment using conservative methods of therapy is recommended. If necessary, the patient is referred to a rheumatologist and endocrinologist for advice.

Surgical Techniques

The type of surgical correction of the fingers is selected depending on the nature and symptoms of the disease. Treatment is aimed at effectively eliminating the deformity disorder.

• lengthening of the extensor tendon;
• Girdlestone-Taylor operation;
• arthrodesis of the joint between the first and second phalanges;
• Corrective osteotomy of the metatarsal bones.

The surgery eliminates the deformity and reduces pain, allowing the patient to lead an active life again. Minimally invasive techniques are used in the early stages of the disease.

Results

The results of treatment largely depend on the stage at which the disease began. The earlier the therapy is started, the better the chances of regaining full mobility of the fingers.

rehabilitation and lifestyle

During rehabilitation, it is important to follow all the doctor's recommendations, especially if surgery was performed. The load on the joints should be measured. The drugs prescribed by the doctor should be taken according to the agreed schedule, and the dose should not be exceeded or reduced on one's own initiative.

A word of warning! To speed up recovery after surgery, physiotherapy treatment may be prescribed.

Lifestyle in ligamentitis

People suffering from ligamentitis need to rethink their lifestyle. You must observe the principles of industrial hygiene. Avoid overloading your joints, remember to take breaks from work and change activities regularly. The above recommendations should also be followed during sports. It is important not to overload the ligaments.

Let yourself be diagnosed in a modernly equipped clinic, recognize ligament inflammations at an early stage and start the therapy in good time. CT, MRI, ultrasound and consultations with experienced doctors are possible on site.

deformity of the toes

A deformity is a condition in which the toes take on an irregular shape. Deformities can affect one toe (usually the big toe) or multiple toes. The main cause of these changes is the uneven development of the muscles that control the toes, causing them to develop unevenly and bend more in a certain direction. All this ultimately leads to deformation of the joint.

causes of the problem

The main causes of deformities are:

• Lack of physical activity over a long period of time.
• peripheral neuropathy.
• diabetes.
• Damage to individual nerves, parts of the brain.
• traumatic influences.
• Wearing unsuitable footwear.

treatment of deformities

The doctor conducts a visual examination of the patient's foot, if necessary, sends the patient for an X-ray examination and prescribes a treatment program. As a rule, the treatment program is conservative, that is, everything is done to prevent further progression of the disease. Wearing special shoes that support the foot in a certain position, physical exercises and therapeutic massage are mandatory.

In severe cases (when the quality of life is impaired), surgical treatment is performed. The main goal of such an operation is to eliminate pain. The appearance of the foot can be affected, so the patient should be morally prepared for the consequences of the procedure.

first of allThe first thing you can do (and definitely should do) is to choose big, spacious, well-fitting shoes. It is best to buy orthopedic shoes or have a pair made to measure.

Secondly. Taking non-steroidal pain-relieving drugs such as ibuprofen, naproxen. Consultation with your doctor is mandatory.

The third are corticosteroid injections. These relieve the swelling and pain syndrome.

Fourth – you must prevent the formation of calluses. Go to a surgeon to remove the ones that are present—otherwise, infection may result.

Fifth: Exercise therapy and physiotherapy are an effective means of treating deformity changes.

Surgical treatment can be performed together or separately: removal of the joint with fusion of the phalanges, removal of the phalanx, severing of the damaged tendons pulling the finger. As a reminder, surgical treatment is performed when other techniques are ineffective. The optimal treatment regimen in each case is determined by the doctor after a thorough examination of the problem.

valgus Failure of the short flexion of the big toe

Halgus valgus (ossicularis) means that the short thumb flexor (Latin: flexor hallucis brevis muscle), the muscle in the plantar part of the foot that flexes the big toe, has long stopped working. The job of this muscle is to flex the big toe at the metatarsophalangeal joint in the final phase of the step.

The short thumb flexor plays an important role in walking - it guides the foot as it strikes and pushes it off in the final stages of the movement before the foot lifts off the ground.

This muscle is involved in generating thrust and helps keep the foot from tipping inward. It also strengthens the arch on the inside of the foot.

By deactivating the short flexor muscle, sooner or later the gluteal muscles, which play an important role in walking and running, will be turned off. They then develop an overstretched 'duck gait', which causes the big toe to continue to bend and the bunion to enlarge.

Ground

Wearing high-heeled shoes, shoes that are narrow (in the toe area), or shoes that are too small aggravates this muscle.

You can also improve the condition of your foot with a growing bunion (valgus). Watch your gait every day.
And remember to push off with your thumb in the final stages of the stride (before your foot lifts off the ground). This push off strengthens the flexor of the big toe and strengthens the arch of the foot. Wear comfortable, wide shoes at home (and outdoors).

The addition of a big toe feature at the end of the stride widens the contact area of the foot and takes some stress off the 'ankles'. And the ankle will contract.

You can also tighten another important muscle in the big toe. It's called the 'big toe extensor muscle'.

Flexor hallucis brevis muscle - Wikipedia

B The short toe flexor muscle (flexor hallucis brevis) is the muscle of the foot that flexes the big toe.

B The flexor hallucis brevis of the big toe located just below the bones of the foot and toes. As its name suggests, its contraction causes the big toe to flex.

It is formed by a sharp tendon branch from the medial aspect of the inferior aspect of the elbow, from the adjacent portion of the third sphenoid bone, and from the extension of the posterior tibial tendon, which attaches to this bone.

It divides into two parts anteriorly, which attach to the medial and lateral sides of the base of the first phalanges of the big toe, with the sesamoid being present in each tendon at its point of attachment.

The medial part is aligned with the adductor of the big toe in front of its insertion; the lateral part (sometimes called the first plantar interdigital muscle) with the head of the adductor of the big toe. In the groove between them lies the tendon of the big toe flexor (flexor longus).

denervation

The medial and lateral heads of the short big toe flexor are innervated by the median plantar nerve. Both heads are represented by the dorsal segments S1, S2.

variants

The origin can be significant; it often receives fibers from the heel bone or longitudinal ligament. The attachment to the elbow bone is sometimes absent. Slide onto the first phalanx of the second toe.

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