The bone of the foot that goes to the toe is called. Frequent foot diseases

If we consider the foot as a whole, then, as in any other part of the human musculoskeletal system, three main structures can be distinguished: the bones of the foot; ligaments of the foot, which hold the bones and form joints; foot muscles.

Foot bones

The foot skeleton consists of three sections: tarsus, metatarsus and toes.
Tarsal bones
The posterior part of the tarsus is made up of the talus and calcaneus, the anterior part is made up of the navicular, cuboid and three cuneiform bones.

Talus located between the end of the leg bones and the heel bone, being a kind of bone meniscus between the bones of the leg and the bones of the foot. The talus has a body and a head, between which there is a narrowed place - the neck. Body on top surface has an articular surface - a block of the talus, which serves for articulation with the bones of the lower leg. On the anterior surface of the head there is also an articular surface for articulation with the scaphoid bone. On the inside and external surfaces the body contains articular surfaces that articulate with the ankles; on the lower surface there is a deep groove separating the articular surfaces, which serve for its articulation with the calcaneus.

Calcaneus makes up the posteroinferior part of the tarsus. It has an elongated, laterally flattened shape and is the largest among all the bones of the foot. It distinguishes the body and a well-palpable tubercle protruding posteriorly calcaneus. This bone has articular surfaces that serve to articulate superiorly with the talus and anteriorly with the cuboid. There is a protrusion on the inside of the heel bone that supports the talus.

Scaphoid located at the inner edge of the foot. It lies in front of the talus, behind the sphenoid bones and inside the cuboid bones. At the inner edge, it has a tuberosity of the navicular bone, facing downwards, which can be easily felt under the skin and serves as an identification point for determining the height of the inner part of the longitudinal arch of the foot. This bone is convex anteriorly. It has articular surfaces that articulate with adjacent bones.

Cuboid is located at the outer edge of the foot and articulates at the back with the heel, inside with the navicular and external cuneiform, and in front with the fourth and fifth metatarsal bones. Along its lower surface there is a groove in which the tendon of the peroneus longus muscle lies.

Sphenoid bones(, intermediate and) lie in front of the scaphoid, inside the cuboid, behind the first three metatarsal bones and make up the anterior internal section of the tarsus.
Metatarsus bones

Each of the five metatarsal bones is tubular in shape. They distinguish between the base, body and head. The body of any metatarsal bone is shaped like a triangular prism. Most long bone is the second, the shortest and thickest is the first. At the bases of the metatarsal bones there are articular surfaces that serve for articulation with the tarsal bones, as well as with the adjacent metatarsal bones, and on the heads there are articular surfaces for articulation with the phalanges of the fingers. All metatarsal bones with back side easy to palpate, since they are covered with a relatively thin layer of soft tissue. The metatarsal bones are located in different planes and form an arch in the transverse direction.
Finger bones

The toes are made up of phalanges. As on the hand, the first toe has two phalanges, and the rest have three. Often the two phalanges of the fifth finger grow together so that its skeleton can have two phalanges. There are middle and phalanges. Their significant difference from the phalanges of the hand is that they are short, especially the distal phalanges.

On the foot, as well as on the hand, there are sesamoid bones. Here they are expressed much better. They are most often found in the area where the first and fifth metatarsals meet the proximal phalanges. Sesamoid bones increase the transverse arch of the metatarsus in its anterior section.

Ligamentous apparatus of the foot

The mobility of the foot is ensured by several joints - ankle, subtalar, talocaleonavicular, tarsometatarsal, metatarsophalangeal and interphalangeal.
Ankle joint

The ankle joint is formed by the bones of the lower leg and the talus. The articular surfaces of the bones of the lower leg and their ankles, like a fork, cover the block of the talus. The ankle joint has a block-like shape. In this joint around the transverse axis passing through the block of the talus, the following are possible: flexion (movement towards the plantar surface of the foot) and extension (movement towards its dorsal surface). The amount of mobility during flexion and extension reaches 90°. Due to the fact that the block at the back narrows somewhat, when the foot is flexed, some adduction and abduction becomes possible. The joint is strengthened ligaments located on its inner and outer sides. Located on the inner side, the medial (deltoid) ligament is approximately triangular in shape and runs from the medial malleolus towards the navicular, talus and calcaneus bones. WITH outside there are also ligaments running from the fibula to the talus and calcaneus (anterior and posterior talofibular ligaments and calcaneofibular ligament).
One of the characteristic age-related features of this joint is that in adults it has greater mobility towards the plantar surface of the foot, while in children, especially newborns, it moves towards the dorsum of the foot.
Subtalar joint

The subtalar joint is formed by the talus and calcaneus and is located in their posterior section. It has a cylindrical (somewhat spiral) shape with an axis of rotation in the sagittal plane. The joint is surrounded by a thin capsule equipped with small ligaments.
Talocaleonavicular joint

In the anterior section between the talus and calcaneus is the talocaleonavicular joint. It is formed by the head of the talus, the calcaneus (with its anterior superior articular surface) and the scaphoid. The talocaleonavicular joint has a spherical shape. Movements in it and in the subtalar joints are functionally related; they form one combined articulation with an axis of rotation passing through the head of the talus and the calcaneal tubercle. The feet also occur around this axis; range of motion reaches approximately 55°. Both joints are strengthened by a powerful syndesmosis - the interosseous talocalcaneal ligament.
One of the age-related features of the position of the bones and their movements in the joints of the foot is that with age the foot pronates somewhat and its internal arch drops. A child’s foot, especially in the first year of life, has a distinctly supinator position, as a result of which the child, when starting to walk, often places it not on the entire plantar surface, but only on the outer edge.
Tarsometatarsal joints

The tarsometatarsal joints are located between the tarsal bones and between the tarsal and metatarsal bones. These joints are small, mostly flat in shape, with very limited mobility. On the plantar and dorsal surfaces of the foot there are well-developed ligaments, among which it is necessary to note the powerful syndesmosis- a long plantar ligament that runs from the heel bone to the bases of the II-V metatarsal bones. Thanks to numerous ligaments, the tarsal bones (scaphoid, cuboid and three cuneiform) and the I-V metatarsal bones are almost immovably connected to each other and form the so-called hard base of the foot.
Metatarsophalangeal joints

The metatarsophalangeal joints have a spherical shape, but their mobility is relatively low. They are formed by the heads of the metatarsal bones and the bases of the proximal phalanges of the toes. Mostly they allow flexion and extension of the fingers.
Interphalangeal joints

The interphalangeal joints of the foot are located between the individual phalanges of the fingers and have a block-like shape; on the sides they are strengthened by collateral ligaments.

Foot muscles

Muscles that are attached by their tendons to various bones of the foot (tibialis anterior, tibialis posterior, peroneus longus, peroneus brevis, extensor longus and flexor toes), but begin in the lower leg area, are referred to as the calf muscles.

On rear There are two muscles on the surface of the foot: extensor digitorum brevis and extensor digitorum brevis. thumb feet. Both of these muscles originate from the outer and inner surfaces of the calcaneus and attach to the proximal phalanges of the corresponding fingers. The function of the muscles is to extend the toes.

On plantar On the surface of the foot, the muscles are divided into internal, external and middle groups.
Internal the group consists of muscles acting on the big toe: the abductor pollicis muscle; flexor pollicis brevis and adductor pollicis muscle. All these muscles begin from the bones of the metatarsus and tarsus, and are attached to the base of the proximal phalanx of the big toe. The function of these muscles is clear from their name.

TO outdoor This group includes muscles that act on the fifth toe: the abductor of the little toe and the flexor of the little toe. Both of these muscles attach to the proximal phalanx of the fifth finger.
Average group is the most significant. It includes: the short flexor digitorum, which is attached to the middle phalanges of the second to fifth fingers; the quadratus plantae muscle, which attaches to the flexor digitorum longus tendon; lumbrical muscles, as well as dorsal and plantar interosseous muscles, which are directed to the proximal phalanges of the second to fifth fingers. All of these muscles originate on the tarsal and metatarsal bones on the plantar side of the foot, with the exception of the lumbrical muscles, which originate from the tendons of the flexor digitorum longus. All of them are involved in flexing the toes, as well as in spreading them and bringing them together.

When comparing the muscles of the plantar and dorsum of the foot, it is clear that the former are much stronger than the latter. This is due to the difference in their functions. The muscles of the plantar surface of the foot are involved in maintaining the arches of the foot and largely provide its spring properties. The muscles of the dorsal surface of the foot are involved in some extension of the toes when moving it forward when walking and running.
Fascia of the foot

IN lower section The fascia of the lower leg has thickenings - ligaments, which serve to strengthen the position of the muscles passing under them. In front there is a ligament - the upper retinaculum of the extensor tendons, and at the transition point to the dorsum of the foot - the lower retinaculum of the extensor tendons. Under these ligaments there are fibrous canals in which the encircled tendons of the anterior group of leg muscles pass.

Between the medial malleolus and the calcaneus there is a groove through which the tendons of the deep muscles of the back of the leg pass. Above the groove, the fascia of the leg, passing into the fascia of the foot, forms a thickening in the form of a ligament - the retinaculum of the flexor tendons. Under this ligament are fibrous canals; in three of them there are muscle tendons surrounded by synovial sheaths, in the fourth - blood vessels and nerves.
Below the lateral malleolus, the crural fascia also forms a thickening called the retinaculum peronealis, which serves to strengthen these tendons.

The fascia of the foot on the dorsal surface is much thinner than on the plantar surface. On the plantar surface there is a well-defined fascial thickening - the plantar aponeurosis, up to 2 mm thick. The fibers of the plantar aponeurosis have an anteroposterior direction and run mainly from the calcaneal tubercle anteriorly. This aponeurosis has processes in the form of fibrous plates that reach the bones of the metatarsus. Thanks to the intermuscular septa, three fibrous sheaths are formed on the plantar side of the foot, in which the corresponding muscle groups are located.

Used literature
Human anatomy: textbook. for students inst. physical cult. /Ed. Kozlova V.I. - M., “Physical Education and Sports”, 1978
Sapin M.R., Nikityuk D.K. Pocket atlas of human anatomy. M., Elista: APP "Dzhangar", 1999
Sinelnikov R. D. Atlas of human anatomy: in 3 volumes. 3rd ed. M.: “Medicine”, 1967

This article talks about the structure of the human foot and foot. About what functions they perform. In addition, about foot diseases, as well as their treatment.

Functions of the foot

The main functions of the foot include:

Body weight support;
Shifting body weight.

There are also secondary functions:

Bending the foot back;
Plantar flexion;
Flexion;
Lateral rotation;
Median plane reduction;
Extension.

A person uses his foot to move. Thanks to the foot, all movements are made. The fingers also have the function of feathering. That is, you can lean on your fingers when bending over without disturbing your balance.

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Anatomy of the foot

The foot has quite complex anatomy, which has its own characteristics.

The foot consists of four main parts:

Bones of the foot. They in turn are divided into:

Tarsal bones. They have 7 bones in their section: talus, calcaneus, navicular, cuboid, 3 sphenoid bones. The talus is the largest bone and is responsible for the flexibility of the ankle.
Metatarsal bones. The metatarsus has 5 bones in the section. These bones together resemble a pipe. The ends of the bones go into the fingers. They are the ones who provide the movement of the fingers.
Phalanges of the fingers. Between them there are movable joints. There are 14 bones in this section. All fingers except the thumbs have three bones, and the thumbs have two. Thanks to this department, balance is maintained, as well as the ability to make all sorts of small movements.

Joints of the foot.
Muscles.
Vessels and nerves. They are responsible for the blood supply to the foot.

Joints

There aren't enough bones to move around. You also need joints. The largest joint is the ankle joint. It allows the foot to perform various movements. Other joints don't matter as much, but they are responsible for joint flexibility.

The ankle joint has three bones in its section:

Two shanks. They participate in the formation of the joint;
Ram.

There are also small joints:

Subtalar joint;
Talocalcaneal-navicular joint;
Tarsometatarsal joints;
Metatarsophalangeal joints;
Interphalangeal joints.

Ligamentous apparatus

The most important formation that exists on the foot is the longitudinal or long ligament of the sole. It starts from the heel bone and extends to the metatarsal bone.

It has fibers along its entire length, which diverge in different directions. These fibers help strengthen the arch of the foot and support it throughout life. Thanks to the ligaments, the foot can bear certain loads.

Muscles

Without muscles, movement will not occur. Thanks to their contraction, movement occurs. The left and right feet have the same number of muscles.

They can be divided into the following groups:

Dorsal muscles. They include a short extensor digitorum. It is responsible for the movement of all fingers, not counting the thumbs.
Plantar muscles. There are two of them, they are small in size and are responsible for abduction, adduction and flexion of the fingers.

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Blood supply

To supply blood to the feet, the arteries of the foot come into action. The artery is a continuation of the tibial artery. It begins its journey from the ankle joint, passing between the tendons of the long extensor finger.

At this point, the artery is located on the surface and the pulse can be easily determined.

Branches emanate from the artery:

Dorsal metatarsal artery;
Arcuate artery;
Tarsal artery;
Medial artery;
Lateral artery;
Deep plantar artery.

Each artery is responsible for supplying blood to a specific area

Innervation

Innervation is carried out by the longest branches of the lumbar and sacral region.

Innervation involves:

Saphenous nerve;
Innervating the medial edge of the foot;
Lateral dorsal cutaneous nerve;
Peroneal nerve;
Intermediate dorsal cutaneous nerves;
Deep branch of the peroneal nerve.

All these departments innervate different parts of the foot.

Features of the foot joints

Each joint has its own individual characteristics, For example:

Subtalar joint formed by the calcaneus and talus bones. This formation has the shape of a cylinder;
Talocaleonavicular joint formed by the articular surface of these three bones. Located in front of the subtalar joint. The shape of the joint resembles a ball and has some restrictions in movement;
Calcaneocuboid joint. It is located between the calcaneus and cuboid bones. Has the shape of a saddle. Movement can be carried out exclusively around one axis;
Wedge-navicular joint. Five bones take part in its formation: the cuboid, the scaphoid, and the three wedges. The joint is inactive;
Tarsometatarsal joints. These joints connect the bones of the tarsus and metatarsus;
Intermetatarsal joints. They are small in size and connect the metatarsal bones;
Metatarsophalangeal joints formed by five bones that are located at the base of the phalanges of the fingers. The joints are spherical in shape;
Interphalangeal joints of the feet. They connect the proximal phalanges of the fingers with the intermediate ones, and them with the distal ones. They are shaped like blocks. They have a very thin joint capsule.

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Frequent foot diseases

Day after day, a person loads his foot without noticing much attention to it. As a result, injuries may occur, which in turn lead to inflammation and deformation.

Below are the most frequent illnesses stop:

Arthrosis. Most often, the disease occurs in middle-aged women. About forty to fifty years. But there is always an exception. The disease may occur earlier.
The disease most affects the big toe, or more precisely, its metatarsophalangeal joint. In some cases, the disease can be confused with gout due to similar localization.
However, these diseases are completely different.
There are several causes of arthrosis:

Previous foot injuries;
Features of the structure of the feet;
Flat feet;
Excess weight;

The disease has three stages. They proceed very slowly, but make significant progress. With each stage the pain intensifies.

Treatment of the disease must begin at the first stage. This will slow down the development of the disease

Arthritis.
The main causes of arthritis:

Infectious diseases;
Allergy;
Condition after injury;
Systemic diseases;
Diseases of the endocrine system.

With arthritis, you can see the following clinical picture: pain in the affected areas, swelling, redness of the skin over the inflamed area, signs of general intoxication, changes in the foot, and loss of some of its functions.

For treatment, it is necessary to identify the cause of the disease. Treatment should only be prescribed by a doctor. If you self-medicate, you can transform the disease into chronic form, that is, deformation of the joints of the foot

Foot deformities. This means that changes have occurred in the foot. That is, the shape of the foot has changed. There are several types of foot deformities:

Flat feet. The disease can be either congenital or acquired. Congenital, that is, arose as a result of genetic characteristics.
Acquired flat feet occur as a result of excessive stress on the foot, previous rickets, injuries, excess weight, wearing uncomfortable shoes;
Clubfoot. The disease is common. It is congenital, in some cases it can be acquired. For example, as a result of cuts, paralysis, skeletal injuries lower limbs. With this disease, the foot is shortened and has a supinated position.

In addition to these deformations, there are others, but they are extremely rare.

These are not all foot diseases. There are a lot of them. For example, tumors, injuries, etc. similar diseases. It follows from this that if you have at least one suspicious symptom, you should consult a specialist.

Diagnostics

To determine the disease, it is necessary to conduct a diagnosis.

To do this you will need the following:

Collecting the patient's medical history. This will help identify whether a similar disease has occurred in the past, as well as a genetic factor;
Objective examination;
Subjective examination;
Radiography.

Why does flat feet develop?

The reasons for the development of flat feet can be divided into two main groups:

Internal reasons;
External reasons.

Internal reasons include developmental features musculoskeletal system, For example:

Weak connective tissue;
Weakened muscular-ligamentous apparatus;
Genetic predisposition;
Weak physical activity.

TO external factors include environmental factors, for example:

Severe and prolonged physical loads on the feet;
Excess weight, obesity or pregnancy;
Uncomfortable shoes. Therefore, women are much more likely to suffer from flat feet than men.
There is no comfort in shoes with heels higher than 4 centimeters, and this leads to the development of flat feet - heels higher than four centimeters. However, this does not mean that running shoes cannot lead to flat feet.

Prevention of foot diseases

Today it is very common to encounter foot diseases, especially for older people. This happens because a person places more stress on the feet.

In addition to the load, other factors also affect the foot. For example, tight and uncomfortable shoes, and excess weight. It is much easier to prevent a disease than to treat it.

To prevent the disease, the following preventive measures must be observed:

You should wear special insoles and arch supports;
You need to wear shoes with low heels about 3-4 cm;
Actively engage in physical education;
Do not put unnecessary stress on the foot.

However, if the disease has already occurred, It is necessary to do massage and perform therapeutic exercises. In addition, it is necessary to take salt baths. This will significantly speed up the healing process.

In any case, the main element is care. It is necessary to treat your legs and feet as carefully as possible. This will prevent development various diseases stop.

The bones of the foot are 26 small elements connected to each other, fractures or bruises of which will cause harm to the entire body. The parts are connected to each other by ligaments and have significant functions. When you first look at a limb after an injury, you can roughly determine which bone is damaged if you know the anatomy.

Foot structure

The foot is divided into three parts: tarsus, metatarsus and toes.

Tarsus

This top part, connects to the tibia and fibula, participates in the formation of the ankle joint and consists of seven bones:

ram;
calcaneal, forming the heel;
the cuboid, forming a joint with the fourth and fifth metatarsal bones, is located on the outer edge of the foot;
scaphoid;
three wedge-shaped, which are connected to the base of the metatarsal bones - medial, intermediate, lateral.

Metatarsus

Located between the tarsus and fingers, it consists of five tubular metatarsal bones, the heads of which are connected to the phalanges.

Toes

The five toes of the foot consist of phalanges - the first toe is of two, and the rest of three.

Foot bone injuries

The bones of the foot are connected by tight joints, so flip flop legs to the right or left, strong bending forward or backward can lead to dislocations, fractures, or both.
A foot fracture will occur when a massive object falls on the leg or jumps from a great height, hits, or runs over the leg of a car.
Stress fractures of the bones of the foot are found in athletes or people who constantly engage in physical labor. Because of increased load the bones of the foot may crack, a non-displaced injury that is difficult to diagnose by appearance, but the damage is clearly visible on x-rays.
Injury occurs when light loads are placed on the legs in the presence of diseases of the musculoskeletal system, for example, a lack of calcium in the blood, bone tuberculosis or osteoporosis.

All bone fractures are characterized by crepitus of bone fragments - the appearance of a crunch when turning or moving the injured part.
A foot fracture is accompanied by severe pain when the victim does not allow the limb to be touched.
The appearance of swelling at the site of injury. Edema develops due to damage to the blood vessels and lymphatic vessels, the liquid from which pours out under the skin. Increases during the day and decreases at night.
Damage to blood vessels causes the development of a hematoma (bruise), the resorption of which takes a long time.
A characteristic symptom is the behavior of a patient who cannot step on a limb.
Deformation of the damaged area.
The patient says that he heard a click or crunch at the time of injury.
When one of the tarsal bones is injured, a characteristic symptom occurs - the spread of swelling to the ankle joint and above.
When the base of the metatarsal bones is fractured, a characteristic symptom will be that the pain subsides after rest and resumes after physical activity.
Subungual hematoma due to injury to the phalanges of the fingers.

Signs of a foot fracture are varied, but only one of the symptoms may appear, so correct diagnosis only a doctor. For example, a non-displaced injury will not lead to a violent reaction on the part of the victim.

Always go to the hospital if you suspect a fracture or after a severe injury.

Fracture of sphenoid bones

Most often, the medial sphenoid bone is susceptible to injury due to the least protection by the ligamentous apparatus and soft tissues. A foot fracture will be accompanied by dislocation of the metatarsal bones.

The cause is the fall of heavy objects, there are no characteristic symptoms, the diagnosis is confirmed by x-ray. To restore joint function after removing the cast, it is recommended to wear an instep support for about a year.

Metatarsal fractures

They take first place in terms of frequency of occurrence; the causes are falling heavy objects or compression. Can be single or multiple. The metatarsal bones consist of a head, neck and base, so there are three types of bone damage according to their parts.

Symptoms of a single injury: swelling on the back of the foot, slight pain on palpation.
Symptoms of multiple trauma: swelling of the entire foot, severe pain,...

One type of metatarsal bone injury is stress fractures, which occur with constant and excessive load, for example, when practicing ballroom dancing, running, or football.

A common fracture of the fifth bone is a Jones fracture, which is difficult to diagnose, and improper treatment will lead to the persistence of the fracture. This type Fractures occur with repetitive stress.

Always contact a traumatologist in case of injuries, do not refuse an X-ray examination so that the doctor can make a correct diagnosis.

A fracture of the base of an unprotected bone occurs when the leg is turned inward; it may be accompanied by a sprain of the ligaments, so it is often not noticed. The separation of a bone fragment occurs under the influence of traction force from the attached tendons. The base of the bone has a poor blood supply, which ensures prolonged healing and nonunion.

Complications

A foot fracture if not properly treated will lead to foot deformation, the development of arthrosis, and the appearance of the following symptoms:

chronic pain when walking;
inability to stand in one place for a long time;
quickly after walking;
difficult to wear tight shoes.

In the absence of medical manipulation, improper fusion of bone fragments may occur, which will lead to limited or complete absence of movements due to pain and deformation.

Treatment

The most important thing in treatment is rest.
To reduce swelling, apply a cold compress and elevate the limb, which will help relieve unpleasant symptom– hematomas.
Fractures without displacement of bone fragments are treated conservatively - by applying a plaster splint. It protects the foot from movement, from infections and promotes anatomically correct fusion of bones. It is prohibited to remove the splint yourself.
When bone fragments are displaced, surgical intervention is indicated, during which the fragments are compared with each other, avoiding trauma to surrounding tissues. After the procedure, the torn tissues, blood vessels and skin are stitched together. A plaster cast is then applied to immobilize the limb.
If surgical intervention is impossible due to the patient’s health, then the patient is prescribed a traction, which ensures comparison of fragments without the intervention of a surgeon. Longer method.
To improve blood flow in the area of injury and to prevent the development of muscle atrophy, moderate physical activity, physiotherapy and massage are prescribed. Blood supplies nutrients and oxygen, which promotes rapid tissue healing.
If the bones do not heal properly, the bones are broken again and the fragments are aligned correctly, so do not self-medicate.
For better bone healing, follow a diet: more protein and calcium, vitamin D, water, minerals.

Perform exercises as recommended by your doctor (10-15 times each exercise):

flexion and extension of fingers;
sitting on a chair, stand on your tiptoes and sit on your heels;
roll a bottle or stick;
pull your leg towards you;
pull out your toes;
turn the leg to the right;
turning the leg at the ankle joint to the left.

A foot fracture is characterized by severe pain and limited mobility. There may be fractures of different bones, but they have similar symptoms Therefore, consultation with a traumatologist and orthopedist is always necessary. To prevent fractures, you need to follow one rule - take care of yourself and your loved ones!

Fractures of the foot bones account for 2.5-10% of all bone fractures

The article describes the causes of fractures of the wedge-shaped bone of the foot (cuneiform). Symptoms and first aid methods are described. Various treatment methods are being considered.

The human foot has a complex, interconnected structure and performs an important function of support. Therefore any serious damage, including cuneiform fracture, disrupt this function and deprive a person of not only the ability to stand, but also to move independently.

The wedge-shaped bones, except the first, articulate on all sides with other bones of the foot. Therefore, isolated fractures are rare; most often, fractures are combined with dislocations of the metatarsal bones.

The sphenoid bones are connected to each other and to nearby bones

Causes and types of fractures

Cuneiform fractures are quite rare.

The causes of fractures can be:

blows;
pressure;
excessive twisting or flexion of the foot,
pathological fractures that occur in certain diseases when bones become brittle (osteoporosis, oncological diseases, tuberculosis, endocrine diseases).

Carefully! Most common cause injury occurs when falling on back part feet of a heavy object. This mechanism leads to the fact that in most cases, multiple fractures, which are often combined with dislocations of the metatarsal bones.

There are several types of fractures:

with or without displacement of bone fragments;
open and closed fractures;
isolated and multiple fractures;
intra-articular fractures.

Of all the sphenoid bones, the first is most often affected, since it is located at the inner edge of the foot and is less protected than the others. Symptoms will vary depending on the type of fracture.

Symptoms

Main clinical symptoms fracture is swelling that quickly spreads to the front surface of the ankle and pain at the fracture site. There is numbness in the fingers and hematoma. The victim cannot walk or lean on the injured limb.

In a displaced fracture, the foot becomes deformed. The presence of fragments significantly influences the choice of treatment tactics. With an open fracture, all layers of soft tissue are injured and bleeding of varying intensity occurs. Bone is visible in the resulting wound.

This is what an injured foot looks like compared to a healthy one

First aid

If a cuneiform fracture is detected, you need to call an ambulance, then the affected limb must be fixed using improvised means - planks, branches, cardboard and secured with bandages or a scarf, strips of fabric. The victim can be given a painkiller and cold applied to the injured area.

In case of an open fracture, you need to carefully treat the edges of the wound with a disinfectant - hydrogen peroxide, brilliant green, iodine, or as a last resort vodka. Under no circumstances should you attempt to set bone fragments on your own. If possible, you need to transport the victim to the hospital yourself.

Diagnostics

A traumatologist performs diagnostics using standard methods:

Patient interview. The doctor finds out when and under what circumstances the injury occurred, and what symptoms bother the patient.
Inspection. At visual inspection You can detect swelling, hematomas or a wound at the fracture site, and also assume the presence of fragments. On palpation - exacerbation of pain. Functional tests are carried out.
X-ray. Radiographs reveal the severity of the fracture, the presence of fragments or splinters of bones, as well as accompanying dislocation of the metatarsal bones.

Based on the results of clinical and instrumental studies, a final diagnosis is made and treatment is prescribed.

Treatment

Therapy is carried out using different methods, depending on the nature and severity of the fracture. It is mainly aimed at relieving pain and swelling and comparing fragments.

In any case, it is assigned drug therapy and procedures to promote rapid bone healing. Treatment methods can be conservative and surgical.

Conservative treatment

Fractures of the scaphoid bones rarely involve fragments. If they exist, and there are no more than two of them, closed reduction of the fragments is performed and then superimposed gypsum bandage“boot” type with a metal instep support placed inside the sole. The immobilization period is approximately 2 months.

Surgery

In case of a complicated fracture with big amount surgical intervention is indicated for fragments. The operation takes place under general or local anesthesia. The surgeon opens the fracture area, compares bone fragments and fixes them with knitting needles or screws. The cast is applied for six weeks. The pins and screws are removed after 3-4 months.

A specialist will show you how the operation is performed in the video in this article.

The injured leg cannot be stepped on, so the patient moves with the help of crutches. Then he was recommended to wear orthopedic shoes for a year.

Drug therapy

Naturally, with such serious injuries as fractures, you cannot do without taking medicines. The patient is prescribed painkillers and non-steroidal anti-inflammatory drugs, antibiotics, calcium, magnesium, and phosphorus preparations. After removing the cast, you can use local anesthetics and decongestants in the form of creams, ointments, and gels. They are widely available in pharmacies and their prices are quite reasonable.

Recovery period

Rehabilitation begins after applying a cast and removing acute symptomatic manifestations. The patient is prescribed physiotherapy, massage, diet and later exercise therapy. The benefits of these procedures are undeniable.

Table. Recovery after a fracture.

Rehabilitation activities	Description	Photo
Physiotherapy	Physiotherapy plays a crucial role in preventing the development of complications after a fracture and in speedy bone healing. Physiotherapy treatment begins 2-5 days after the injury. They relieve pain and swelling, improve microcirculation in tissues, and accelerate regenerative processes. For fractures, medicinal electrophoresis, magnetic therapy, ultraviolet irradiation, and pulsed currents are prescribed.	Physiotherapy accelerates recovery
Exercise therapy and massage	Therapeutic exercises begin on the third day after the injury. In the first days after a fracture, exercises are performed for a healthy limb and joints free from a plaster cast. After removing the cast, underwater gymnastics is useful. Exercises are performed carefully, without causing pain. When a strong bone callus has already formed, the exercises become more intense, they are aimed at eliminating the consequences of injuries. It is useful to end a set of exercises with a massage session, which helps improve blood circulation, prevent stagnation, eliminate swelling and tone blood vessels. It is better if the massage is performed by an experienced specialist. The patient, after the massage training courses, is given instructions, after which he performs it independently.	Foot massage
Diet	In case of bone fractures, it is recommended to adhere to balanced diet. To restore bones after fractures, elements such as calcium, magnesium, phosphorus, manganese, zinc, vitamins B6, B9, B12, C, D, K are needed. They are found in fish, lean meat, dairy products, cheese, seafood, nuts, legumes, oatmeal and buckwheat, cabbage, spinach, citrus fruits, bananas. These products should be present in the patient's diet every day.	Products - useful for improving bone healing

A cuneiform fracture is a fairly rare but serious injury. With adequate treatment, the victim's health will recover quickly. But in older people, pain in the area of the fracture may continue and there is a high likelihood of developing arthrosis.

The bones of the foot are 26 small elements connected to each other, fractures or bruises of which will cause harm to the entire body. The parts are interconnected by ligaments and have significant functions. When you first look at a limb after an injury, you can roughly determine which bone is damaged if you know the anatomy.

Foot structure

The foot is divided into three parts: tarsus, metatarsus and toes.
Tarsal bones

Tarsus

This upper part, connected to the tibia and fibula, is involved in the formation of the ankle joint and consists of seven bones:

ram;
calcaneal, forming the heel;
the cuboid, forming a joint with the fourth and fifth metatarsal bones, is located on the outer edge of the foot;
scaphoid;
three wedge-shaped, which are connected to the base of the metatarsal bones - medial, intermediate, lateral.

Metatarsus

Located between the tarsus and fingers, it consists of five tubular metatarsal bones, the heads of which are connected to the phalanges.

Toes

The five toes of the foot consist of phalanges - the first toe is of two, and the rest of three.

Foot bone injuries

The bones of the foot are connected by tight joints, so a sharp turn of the leg to the right or left side, a strong bend forward or backward can lead to dislocations, fractures, or both.
A foot fracture will occur when a massive object falls on the leg or jumps from a great height, hits, or runs over the leg of a car.
Stress fractures of the bones of the foot are found in athletes or people who constantly engage in physical labor. Due to increased stress, the bones of the foot can crack, a non-displaced injury that is difficult to diagnose by appearance, but the damage is clearly visible on x-rays.
Injury occurs when light loads are placed on the legs in the presence of diseases of the musculoskeletal system, for example, a lack of calcium in the blood, bone tuberculosis or osteoporosis.

Signs of a broken foot

All bone fractures are characterized by crepitus of bone fragments - the appearance of a crunch when turning or moving the injured part.
A foot fracture is accompanied by severe pain when the victim does not allow the limb to be touched.
The appearance of swelling at the site of injury. Edema develops due to damage to the blood and lymphatic vessels, the fluid from which flows under the skin. Increases during the day and decreases at night.
Damage to blood vessels causes the development of a hematoma (bruise), the resorption of which takes a long time.
A characteristic symptom is the behavior of a patient who cannot step on a limb.
Deformation of the damaged area.
The patient says that he heard a click or crunch at the time of injury.
When one of the tarsal bones is injured, a characteristic symptom occurs - the spread of swelling to the ankle joint and above.
When the base of the metatarsal bones is fractured, a characteristic symptom will be that the pain subsides after rest and resumes after physical activity.
Subungual hematoma due to injury to the phalanges of the fingers.

The signs of a foot fracture are varied, but only one of the symptoms may appear, so only a doctor can make the correct diagnosis. For example, a non-displaced injury will not lead to a violent reaction on the part of the victim.

Always go to the hospital if you suspect a fracture or after a severe injury.

Fracture of sphenoid bones

Traction after a metatarsal fracture

Metatarsal fractures

Symptoms of a single injury: swelling on the back of the foot, slight pain on palpation.
Symptoms of multiple trauma: swelling of the entire foot, severe pain, deformation of the foot.

One type of metatarsal bone injury is stress fractures, which occur with constant and excessive load, for example, when practicing ballroom dancing, running, or football.

Jones's fracture

A common fracture of the fifth bone is a Jones fracture, which is difficult to diagnose, and improper treatment will lead to the persistence of the fracture. This type of fracture occurs due to repetitive stress.

Always contact a traumatologist in case of injuries, do not refuse an X-ray examination so that the doctor can make a correct diagnosis.

Complications

A foot fracture if not properly treated will lead to foot deformation, the development of arthrosis, and the appearance of the following symptoms:

chronic pain when walking;
inability to stand in one place for a long time;
legs get tired quickly after walking;
difficult to wear tight shoes.

In the absence of medical manipulation, improper fusion of bone fragments may occur, which will lead to limited or complete absence of movements due to pain and deformation.

Treatment

The most important thing in treatment is rest.
To reduce swelling, apply a cold compress and elevate the limb, which will help get rid of the unpleasant symptom - hematoma.
Fractures without displacement of bone fragments are treated conservatively - by applying a plaster splint. It protects the foot from movement, from infections and promotes anatomically correct fusion of bones. It is prohibited to remove the splint yourself.
When bone fragments are displaced, surgical intervention is indicated, during which the fragments are compared with each other, avoiding trauma to surrounding tissues. After the procedure, the torn tissues, blood vessels and skin are stitched together. A plaster cast is then applied to immobilize the limb.
If surgical intervention is impossible due to the patient’s health, then the patient is prescribed a traction, which ensures comparison of fragments without the intervention of a surgeon. Longer method.
To improve blood flow in the area of injury and to prevent the development of muscle atrophy, moderate physical activity, physiotherapy and massage are prescribed. Blood provides nutrients and oxygen, which promotes rapid tissue healing.
If the bones do not heal properly, the bones are broken again and the fragments are aligned correctly, so do not self-medicate.
For better bone healing, follow a diet: more protein and calcium, vitamin D, water, minerals.

flexion and extension of fingers;
sitting on a chair, stand on your tiptoes and sit on your heels;
roll a bottle or stick;
pull your leg towards you;
pull out your toes;
turn the leg to the right;
turning the leg at the ankle joint to the left.

A foot fracture is characterized by severe pain and limited mobility. There may be fractures of different bones, but they have similar symptoms, so consultation with a traumatologist and orthopedist is always necessary. To prevent fractures, you need to follow one rule - take care of yourself and your loved ones!

Foot fracture is a pathological situation in which one or more bones of the foot (

the part of the leg that comes into direct contact with the floor

) loses its integrity due to exposure to any traumatic factor or due to a disease affecting bone tissue.

According to statistics, approximately 10% of fractures recorded in trauma centers and hospitals occur in the bones of the foot. This is due to the high functional load determined by body weight, as well as the high frequency of various injuries in the foot area.

Anatomically, the foot consists of 26 bones, connected to each other using complex joints and a large number of ligaments, due to which this section of the leg has sufficient mobility and strength. Due to the elasticity of the ligamentous apparatus, the foot is able to withstand significant pressure and absorb part of the load, thus softening the impacts that occur when walking, jumping and falling. Thanks to this, dynamic loads that act on the foot are absorbed and are not transmitted to the more rigid structures of the legs and body, thereby reducing negative impact negative factors and forces on the body.

Despite the large number of joints in the foot,

in this area occur much less frequently than fractures (

especially in childhood

). This is due, first of all, to low joint mobility, as well as high strength structures that support them.

Fracture of the bones of the foot is a common pathology that poses a danger to human life only in exceptional cases when complications develop. In the vast majority of cases, bone fractures in this area occur easily and without complications.

It should be noted that due to the high functional significance of the foot, a serious fracture without proper treatment can lead to

disability

Particularly dangerous are intra-articular fractures, in which the function of not only the bone, but also the involved joint is disrupted. Moreover, the sharp edges of bone fragments in the joint cavity can cause irreparable structural changes articular surfaces, thereby completely disrupting and blocking its work.

Anatomy of the foot

The human foot is a complex of highly developed biomechanical structures whose main function is to support the weight of the body, as well as to withstand the various forces that arise during various types of movement.

The foot consists of 26 bones, which, according to their location and structural and functional characteristics, can be divided into 3 large groups.

The skeleton of the foot is formed by the following sections:

Tarsus. The tarsus consists of 7 bones (talus, calcaneus, navicular, cuboid and three cuneiforms), which are located between the bones of the lower leg (tibia and fibula) and the bones of the metatarsus. Takes part in the formation of the ankle joint, as well as a number of small, inactive joints of the foot.
Metatarsus. The metatarsus consists of 5 short tubular bones, which connect the phalanges of the fingers to the tarsus. At both ends of these bones there are articular surfaces, which allows you to significantly increase the range of motion of the toes.
Phalanges of the fingers. The phalanges of the fingers are represented by fourteen bones (2 for the first finger and 3 each for the other four). They form a mobile skeleton of the fingers, which are involved in maintaining balance, and also carry out a number of small movements.

This division is based on the structural relationship of the bones and the joints that connect them. However, since the foot is formed not only by bone tissue, but also by many muscles, blood vessels and nerves, ligaments and tendons, skin and subcutaneous tissue, it is usually divided into 3 sections according to their location.

The foot consists of the following areas:

Back of the foot. At the back of the foot are the talus and calcaneus bones.
Midfoot. The midfoot contains the navicular, cuboid, and three cuneiform bones.
Forefoot. The forefoot includes the 5 metatarsal bones and the phalanges of the toes.

This division is quite convenient clinically, so some authors classify foot fractures according to these areas.
Bone skeleton of the foot

As mentioned above, the bony skeleton of the foot is formed by 26 bones, which are connected to each other using inactive joints. The bones of the foot are constantly exposed to intense loads, since they bear the weight of the human body, and also take part in absorbing the energy generated during movement, falling, and landing.

The skeleton of the foot is formed by the following bones:

Heel bone. The calcaneus is largest bone feet. It is located in the back of the foot, so it experiences maximum load when the heel touches the ground. The bone protrudes slightly posterior to the ankle joint, thereby forming a lever of force that allows calf muscle develop greater force, which facilitates plantar flexion of the foot and allows you to rise on your toes and perform jumps. The calcaneus is a complex three-dimensional rectangle, the long axis of which is oriented anteriorly and slightly laterally, and which bears 6 surfaces. In the anterior part of the upper surface of the bone there is an area that takes part in the formation of the joint with the talus, and in the posterior part there is a tuberosity to which the Achilles tendon is attached. The lower part of the calcaneus expands posteriorly to form the plantar protuberance. The anterior surface of the bone bears cartilage tissue, which is involved in the formation of the joint with the scaphoid bone. On all surfaces of the heel bone there is a fairly large number of protrusions and depressions, which are necessary for the attachment of muscles, as well as for the passage of nerves, blood vessels and tendons.
Talus. The talus is the second largest bone in the foot. This bone is unique because more than two-thirds of its area is occupied by the articular surface, and also because no muscle or tendon is attached to this bone. The talus bears five articular surfaces, each of which is covered with thin hyaline cartilage. The structure of this bone is divided into a head, neck and body. The head is the anterior portion of the bone that forms a broad, oval and concave articular surface for articulation with the scaphoid. The neck is a small area of bone located between the body and the head that is most vulnerable to fracture. The body of the talus is located above and behind its head and neck and bears articular surfaces for articulation with the tibia and fibula, the medial and lateral malleolus, and the calcaneus.
Cuboid. The cuboid bone is located on the lateral (side) part of the foot, anterior to the heel bone and posterior to the fourth and fifth metatarsals. The cuboid bone is cubic in shape (as is clear from its name), but its base is wider than the other sides and oriented medially.
Scaphoid. The navicular bone is located in the midfoot between the head of the talus at the back and the three cuneiform bones at the front. This bone takes part in the formation of the main part of the arch of the foot. Forms joints with the talus and three sphenoid bones. Sometimes it may contain articular surfaces for the fifth metatarsal or cuboid bone.
Sphenoid bones. The sphenoid bones are represented by three small bones located one next to the other. On the posterior surface of these bones there are articular surfaces for connection with the scaphoid bone, and on the anterior surface for connection with the metatarsal bones.
Metatarsal bones. The metatarsal bones are represented by five short tubular bones that have some upward curvature, thanks to which they participate in the formation of the arch of the foot. The metatarsal bones bear two articular surfaces (one at each end) and a number of tuberosities necessary for the attachment of muscles and tendons.
Phalanges of the fingers. The phalanges of the toes correspond in number and relative arrangement of bones to the fingers of the hand. The skeleton of the first finger is formed by two phalanges, the skeleton of fingers from the second to the fifth is formed by 3 phalanges. The differences between the toes and the fingers lie in their size, since the phalanges of the toes are much shorter and thicker. This is due to the functional load that the bones of this area experience when moving the body.
Sesamoid bones. Sesamoid bones are small bone formations located in the thickness of the tendon, which in their shape resemble sesame seeds. These bones are usually located above the joints and serve to move the tendons away from the joint space and also to increase the leverage.

One of the most important functions of the foot is shock absorption, which is carried out due to the arched structure of the foot and the elasticity of the ligamentous apparatus. The arch of the foot is a certain bend located in the middle part of the foot, formed by the metatarsal and tarsal bones, which, due to its elasticity and some mobility, can significantly absorb the energy of impacts.

Flat feet

is a common pathology in which the arch of the foot is simplified and, accordingly, the shock absorption function is somewhat impaired. This leads to the fact that dynamic impulses arising during movement and impacts are insufficiently absorbed and are transmitted to the bones of the foot, legs, and

spine

and body. As a result, the risk of developing a number of pathologies of the musculoskeletal system, including fractures of the bones of the foot, increases.

Foot joints

The foot is an extremely complex anatomical structure, containing a large number of complex joints formed by two or more bones. The main joint of the foot is the ankle joint, formed by the tibia and fibula and their lateral processes (

) on one side, and the talus on the other. This joint provides maximum mobility of the foot and allows you to perform many complex movements. The remaining joints of the foot are less important in terms of movement of this part of the leg, but provide the necessary elasticity and resilience.

The following joints are located in the foot area:

Ankle joint. The ankle joint is formed at the point where the ends of the tibia meet the talus. The peculiarity of this joint is that due to the presence of lateral processes (ankle), these bones clasp the talus from the sides, thereby forming a kind of block. This joint is strengthened articular capsule, as well as a number of ligaments running along the sides of the joint. Thanks to these features, this joint is capable of performing movements of anterior and posterior flexion within a fairly wide range, while lateral flexion is limited. Moreover, lateral flexion, combined with exposure to a traumatic factor, often leads to an ankle fracture.
Subtalar joint. The subtalar joint is a relatively inactive joint between the talus and calcaneus.
The talocaleonavicular joint. The talocaleonavicular joint is formed by the articular surfaces of the corresponding tarsal bones. A powerful ligament passes through the cavities of this and the subtalar joints, which connects the heel and talus bones.
Calcaneocuboid joint. The calcaneocuboid joint is formed by the articular surfaces of the calcaneus and cuboid bones. Together with the talocalcaneal-navicular joint, it forms a transverse tarsal joint (Chopard's joint), the articular space of which, bending slightly, cuts the foot almost perpendicular to its axis. This joint is strengthened by one common bifurcated ligament, which begins on the heel bone, and then is attached at one end to the cuboid bone, and at the other to the scaphoid. This ligament is sometimes called the “Chopard joint key”, since only after its dissection can a wide divergence of the joint space be achieved, which is necessary in some surgical interventions on the foot.
Wedge-navicular joint. The sphenonavicular joint is formed by the articular surfaces of the sphenoid and scaphoid bones.
Tarsometatarsal joints. The tarsometatarsal joints are involved in connecting the tarsal bones with the short tubular bones of the metatarsus. These joints are inactive, the articular capsule and the ligaments that strengthen them are tightly stretched, due to which they participate in the formation of the elastic arch of the foot.
Intermetatarsal joints. The intermetatarsal joints are formed by the protruding parts of the heads of the metatarsal bones facing each other.
Metatarsophalangeal and interphalangeal joints. The metatarsophalangeal and interphalangeal joints serve to attach the phalanges of the toes to the metatarsus. They are similar in structure to the joints of the hand, but the range of possible movements is somewhat limited.

The main ligament of the foot is the long plantar ligament, which stretches from the posterior edge of the lower surface of the heel bone to the base of the metatarsals. On its way, this ligament gives off many fibers that significantly strengthen it and connect the bones of the foot into a single structural and functional unit.

A large number of elastic elements in the structure of the foot, combined with the anatomical features of the bones and low mobility of a number of joints, deprive the foot of sufficient rigidity and elasticity, due to which the leg is able to withstand significant dynamic and static loads.

Foot muscles

Movement of the foot occurs as a result of contraction of the lower leg muscles and the intrinsic muscles of the foot. It should be noted that foot movements are largely mediated by the activity of the lower leg muscles.

Movement of the foot is provided by the following groups of muscles of the lower leg:

Anterior muscle group. The anterior muscle group of the lower leg is represented by the tibialis anterior, extensor digitorum longus and extensor pollicis longus muscles. These muscles are involved in the dorsiflexion movements of the foot (extension), as well as in the extension movements of all fingers in general and the big (first) toe in particular.
Lateral muscle group. The lateral muscle group of the lower leg is represented by the peroneus longus and peroneus brevis. These muscles are involved in lateral flexion (pronation) of the foot.
Back group. The posterior muscle group is the most massive and contains several layers of muscles. This area contains the triceps surae (composed of the gastrocnemius and soleus), plantaris, flexor digitorum longus, tibialis posterior and flexor pollicis longus. These muscles are involved in plantar flexion of the foot (thanks to the Achilles tendon, which arises from the triceps muscle and is attached to the posterior edge of the heel bone), as well as in the flexion of all toes.

The intrinsic muscles of the foot are represented by the following muscle groups:

Dorsal muscles of the foot. The dorsal muscles of the foot are represented by the short extensor digitorum, which originates from the edge of the heel bone and takes part in the extension of the first four toes.
Plantar muscles of the foot. The plantar muscles of the foot are represented by several muscles that perform the movements of flexion, abduction and adduction of the toes.

Nerves and blood vessels of the foot The foot is supplied with blood from the branches of the anterior tibial and posterior tibial arteries, which at the level of the foot pass into the dorsal artery of the foot, as well as into the lateral and medial plantar arteries. These blood vessels form many connections and form a closed arc, due to which blood circulation is maintained even if one of the arteries is damaged. However, disruption of the integrity of the vessels of the foot in combination with atherosclerotic changes can cause severe blood loss and ischemia of the limb with irreparable tissue damage.

The foot communicates with the central nervous system through a number of peripheral nerves (

posterior tibial nerve, superficial and deep peroneal nerve, sural nerve

). Thanks to the system of nerve fibers, sensations arising in the foot area (

feeling of touch, cold or heat, vibration, pain, position in space

), are transmitted to the spinal cord and brain, where they are processed. In addition, nerve fibers are involved in the transmission of descending impulses from the central nervous system to the periphery, and more specifically to the muscles. Thanks to this stimulation, voluntary muscle contractions occur, as well as a number of involuntary responses (

reflexes and changes in vascular tone, changes in the secretion of sebaceous and sweat glands and other reactions

Thus, the foot is a complex anatomical and functional structure, which consists of a large number of bones, ligaments, muscles, vessels and nerves and bears a high dynamic and static load. In this regard, fractures in this area are quite common. Due to the large number of bones that can be damaged during a fracture, and the joint spaces that separate the places of normal anatomical articulation of these bones, diagnosis and precise localization of the fracture site pose some difficulties.

Causes of foot fractures

A fracture of the bones of the foot, like any other fracture, develops under the influence of a force that exceeds the elastic force of the bone. A similar situation can arise both with high intensity of the influencing factor (

traumatic fracture

), and with a decrease in bone strength (

pathological fracture

It should be noted that due to the high intensity of static and dynamic loads to which the foot is exposed, stress or load fractures can occur in this area, which in essence are somewhere between traumatic and pathological fractures.

Traumatic fractures of the foot bones

According to statistics, the vast majority of all fractures, including foot fractures, are traumatic. Fractures occur as a result of direct or indirect exposure to a high-intensity traumatic factor on bone structures. Typically, a fracture occurs either at the site of impact or at the weakest point of the bone.

Traumatic fractures are characterized by one of the following mechanisms of occurrence:

Excessive axial load on the bones of the foot can cause a fracture of any of the bones, but the most common fracture occurs in the heel bone. This fracture mechanism develops either as a result of a vertical fall from a height, or as a result of road accidents (when pedals are applied to the plantar surface of the foot).

Excessive rotation. Excessive rotation of the foot can cause an extra-articular calcaneal fracture. The impact of a traumatic factor on a foot in a position of internal or external rotation (pronation or supination) often causes not only a fracture of the bones of the foot, but also a fracture of one or both ankles.

Excessive dorsiflexion of the foot. Excessive dorsiflexion of the foot combined with a strong impact from a fall or traffic accident will result in a fracture of the neck of the talus in most cases. Also, such an injury is often combined with a fracture of the anterior edge tibia.

Direct impact. Often the bones of the foot are damaged as a result of direct impact mechanical factor on the foot. This usually occurs during road accidents, after falls, after jumping from a great height, after any heavy objects fall on the foot.

Other mechanisms. Damage to the bones of the foot can occur under the influence of various types traumatic effects and in different positions of the foot. This creates a significant variety of possible traumatic fractures in this area, as well as some difficulties in diagnosis.

It should be noted that about 10–15% of fractures of the bones of the foot are open, that is, bone fragments formed after damage to the bone, soft tissue and skin come into contact with the environment. Open fractures are more dangerous, as they pose a potential threat of bacterial infection and can provoke a number of infectious complications. In addition, the bleeding that occurs with open fractures is usually more massive and prolonged. This is due to the fact that with an open fracture, blood from the damaged vessel flows directly into the environment.

Such a high frequency open fractures explained by the proximity of the skin to the bone structures in combination with a thin layer of subcutaneous tissue and soft tissue. In addition, it should be understood that the traumatic factor affects not only the bones, but also the skin and other tissues located along the axis of its impact. For this reason, bruises, abrasions and even open defects are often found in the area of trauma.

It should be noted that any fracture combined with a skin defect is considered open. This is due to more high risks, described earlier, and, accordingly, with a different therapeutic approach.

Exposure to a high-intensity traumatic factor often causes not only a bone fracture, but also subsequent displacement of bone fragments. It should be noted that due to anatomical features foot, in which the bones are pressed quite tightly against each other with the help of powerful ligaments and tendons, displacement of fragments occurs more often with a fracture of the talus, calcaneus, metatarsal bones and bones of the phalanges of the fingers.

In order for displacement of bone fragments to occur, that is, in order for a violation of the normal relationship of bones to occur, several conditions must be met. Firstly, the fracture must be complete, that is, it must cover the entire circumference of the compact substance of the bone, since otherwise, with an incomplete fracture, only some distance of the bone fragments can occur, but not their displacement. Secondly, the traumatic factor must be strong enough to cause not only a bone fracture, but also the displacement of its fragments.

The fact that bone fragments are displaced is extremely important when diagnosing a fracture and planning treatment, since often displaced fragments must be compared through surgery.

Pathological fractures of the foot bones

Pathological fractures of the bones of the foot occur in situations where, due to a decrease in the resistance of bone tissue, it is damaged under the influence of a minor traumatic factor during normal daily activity. Pathological fractures make up a relatively small proportion of all fractures.

The occurrence of a pathological fracture indicates the presence of some systemic or local disease of the bone, which in some way disrupted its structure and thereby weakened it. Most often, this type of fracture is based on impaired metabolism of minerals, which develops due to age-related and hormonal disorders.

Pathological fractures may be caused by the following bone diseases:

Osteoporosis. Osteoporosis is a pathological condition in which the process of bone tissue synthesis and its mineralization (strengthening with calcium salts) is disrupted. As a result, the compact substance of the bones is depleted, the bone beams become less pronounced, and the skeleton loses its strength and elasticity.
Osteomyelitis. Osteomyelitis is a severe infectious disease in which the infectious-inflammatory focus is located within the bone tissue and bone marrow. The systemic and local inflammatory response that occurs during osteomyelitis provokes a number of pathological changes, against the background of which the nutrition of the bone is disrupted and its gradual weakening occurs.
Tumors of bone tissue or bone marrow. Bone and bone marrow tumors cause severe thinning and weakening of bones, increasing the risk of fracture when exposed to low-intensity stimuli. In addition, neoplastic processes often provoke nonspecific aching pain in the area of the affected bone, which causes significant discomfort to the patient.
Genetic abnormalities. For some genetic abnormalities the process of bone mineralization and bone tissue formation is disrupted, which leads to bones becoming more fragile.
Admission Not sufficient quantity nutrients and minerals from food. Building bone tissue is a complex process that requires sufficient amounts of energy, nutrients, vitamins and minerals. Their deficiency can cause reduced bone strength. It should be noted, however, that metabolic and structural changes in bones develop somewhat more slowly than in other tissues, therefore, in order for changes in bone tissue to occur against the background of insufficient nutrient intake, a significant period of time is required.

It should be noted that weakening of bone tissue often occurs while taking certain medicines, which disrupt the metabolism of nutrients, change hormonal balance or directly activate the system responsible for the “resorption” of bones.

The following groups of drugs can reduce bone strength:

steroid hormones;
thyroid hormones;
direct and indirect anticoagulants (for example, heparin);
lithium preparations;
anticonvulsants;
cytostatics and other chemotherapy drugs used to treat tumors;
tetracycline antibiotics.

It is necessary to understand that changes in the structure of bone tissue occur only when taking these medications for a sufficiently long time, and that with a short course of treatment this complication should not be feared. If necessary long-term use of these drugs, it should be understood that the benefits of their use exceed possible risks associated with fractures.
Stress fractures of the foot bones

Stress fractures of the bones of the foot are a pathological situation in which a fracture develops against the background of constant and prolonged exposure to a low-intensity traumatic factor.

Stress fractures of the bones of the foot most often occur among people who, due to their professional activities or some other circumstances, are forced to long time be subjected to intense and repetitive stress. Most often, these fractures are found among professional athletes (

especially track and field athletes

), dancers, and also among recruits (

march fractures

). In addition, this type of fracture is typical for people with

rheumatoid arthritis

and a number of other pathologies affecting bone tissue.

Stress fractures most often affect the metatarsal bones, since they bear the maximum load when running and jumping. Changes in the arch of the foot that are observed with flat feet significantly increase the risk of developing this disease.

Symptoms of a fracture of the bones of the foot A fracture of the bones of the foot is a pathology that is accompanied by quite pronounced symptoms that make it possible to immediately suspect this disease. However, based on clinical picture It is impossible to accurately determine the broken bone and the type of fracture.

The main symptom of a foot bone fracture is pain, which can be different intensities and localization depending on the location of the fracture. Pain occurs due to damage to the periosteum (

thin connective tissue film covering the outside of the bone

), which contains a large number of nerve fibers and pain receptors. In addition, the aseptic inflammatory reaction that occurs at the site of fracture and injury (

aseptic means that inflammation develops without the participation of an infectious factor

) produces a large amount of biologically active substances that, one way or another, affect nerve endings and either increase their sensitivity to pain or directly stimulate them.

and dysfunction of the injured limb also accompany the fracture in the vast majority of cases. Swelling develops against the background of an inflammatory reaction, as this causes the dilation of blood vessels and increases their permeability, which accelerates the release of fluid from the bloodstream into the tissue. Limitation of limb function is caused by severe pain, which does not allow a person to make full movements and step on the foot.

Crepitation (

) bone fragments, which is observed in fractures of long tubular bones of the extremities, may be absent in a fracture of the foot, due to the rather rigid fixation of bones and bone fragments by the elastic structures of this section of the leg.

Symptoms of a calcaneal fracture

Patients with a calcaneal fracture typically complain of moderate to severe pain in the heel area, accompanied by swelling and redness. The heel becomes sensitive to touch; slight contact with the skin can cause pain (

reflex increase in the sensitivity of nerve fibers and pain receptors

). Due to swelling, the heel increases in volume.

Often the skin around the heel bone reveals abrasions and bruises, which can extend to the arch of the foot and are one of the signs of a fracture of this bone.

In some cases, blisters and wet

Which arise due to massive swelling and separation of the upper layer of skin. Typically, this symptom develops no earlier than one and a half to two days after the injury.

Open fractures, as mentioned above, often accompany fractures of the bones in this area. Usually the skin defect is located medially, that is, on the side facing the other leg.

When the neurovascular bundle is damaged, blood loss occurs, which, in the presence of a skin defect, can be quite voluminous. In some cases, due to impaired blood supply to the tissues of the foot, ischemia develops, which can have extremely adverse consequences, including the death of the limb. Nerve damage results in decreased or impaired sensation in the affected area. In some cases, compression of the nerve trunk may result in a syndrome chronic pain, the treatment of which is quite complex.

It should be borne in mind that due to the fact that a fracture of the foot most often occurs as a result of exposure to a fairly strong traumatic factor, in almost half of the cases it is combined with a fracture of bones in other areas.

A calcaneal fracture may be accompanied by the following pathologies:

fracture of the lumbar vertebrae;
fracture of other bones of the lower extremities.

Symptoms of a fracture of the talus A fracture of the talus is usually accompanied by severe pain, which intensifies with pressure on the top of the foot, when trying to transfer weight to the affected limb, as well as when moving the ankle joint. In addition to the mechanisms of pain listed above, the talus is characterized by another one associated with the localization of the fracture line inside the joint cavity and, accordingly, with irritation of the delicate articular surfaces by the sharp edges of bone fragments. This also significantly limits the mobility of the foot.

Crepitation of bone fragments, which occurs when the edges of bones rub against each other, in a fracture of the talus can be detected during movements in the ankle joint.

A fracture of the talus is usually accompanied by diffuse swelling of the entire foot or its forefoot. This increases the sensitivity of this area to palpation.

Often, a fracture of the talus is accompanied by a fracture of other bones of the foot, as well as a fracture of one or both ankles.

Symptoms of a midfoot and forefoot fracture

A fracture in the midfoot or forefoot usually presents in the same way, regardless of the bone affected. Most constant symptom is a pronounced pain sensation in the front third of the foot, which intensifies with palpation and pressure.

Foot swelling can vary in severity - from barely noticeable enlargement and redness of the dorsum of the foot to severe swelling with severe deformation of the limb.

In most cases, the skin in the area of the fracture is also damaged. This usually manifests itself as bruising, abrasions,

bruises on the skin

Flexion, adduction and abduction of the foot, as well as its extension, are movements that in most cases cause exacerbation of the pain syndrome and make it possible to identify instability of bone fragments (

displacement of bone fragments relative to each other

Symptoms of a stress fracture in the foot

Stress fractures of the metatarsal bones of the foot in the vast majority of cases are blunt, aching pain, which initially occur only during exercise or when a load is applied to the foot, but over time they become more constant and bother the patient even at rest. Pain from stress fractures is usually diffuse, meaning it spreads throughout the entire foot. Precise localization of pain at the fracture site is typical for old fractures.

Swelling, redness, and deformity of the foot are less severe with stress fractures than with other types of traumatic foot fractures.

In most cases, stress fractures of the foot occur due to increased physical activity. These fractures are typical for professional and non-professional athletes who, for some reason, have increased the intensity of training, as well as for recruits who, without prior training, are forced to undergo high physical exertion and run long distances in inappropriate shoes and with heavy equipment.

Diagnosis of foot fractures

The main method for diagnosing fractures of the foot bones is radiological examination, which allows you to accurately identify the location and type of fracture. However, it should be understood that before taking an x-ray, the doctor must conduct clinical examination patient and decide only on the basis of the data obtained whether this patient needs to take a picture or not. Moreover, it is a conversation with a doctor and a clinical examination that allows one to suspect a foot fracture and identify possible signs accompanying pathologies.

Today, most clinical traumatologists use various guides and manuals in their practice, which describe specific symptoms and signs of possible fractures and provide clear instructions and recommendations for the diagnostic and treatment process. Most guides discuss some criteria on the basis of which the doctor decides whether the patient needs

Radiological examination of the ankle and foot is indicated in the following cases:

serious injury to the ankle area, accompanied by severe pain;
increased tenderness in the lower part of the tibia and medial malleolus or fibula and lateral malleolus;
inability to support your weight on the injured leg;
inability to take four steps;
increased sensitivity in the area of the fifth metatarsal bone;
increased sensitivity and pain in the scaphoid area.

These signs allow, based on the clinical picture, to differentiate possible fractures from other, milder foot injuries. This is necessary in order to avoid exposing people to unnecessary exposure to X-rays.

X-rays are ionizing electromagnetic radiation, which is capable of penetrating objects and forming an image on a special film. At its core X-rays are radioactive, therefore frequent and unnecessary x-ray examinations should be avoided. However, it should be understood that when we're talking about about the diagnosis of fractures (

and not only

) the advantages of this method outweigh its disadvantages.

Fabrics human body capable of absorbing x-rays to varying degrees. It is on this property that radiological research is based. The fact is that bone tissue is capable of almost completely absorbing X-rays, while soft tissues (

muscles, subcutaneous fat, skin

) absorb them only slightly. As a result, rays passing through the body or part of the body form a negative image in which bone tissue and dense structures appear as shadows. If there are any defects in the bone structure, a clear fracture line is displayed on the film.

Since the image generated during a radiological examination is two-dimensional, and often some structures on it are superimposed on each other, in order to obtain a sufficient amount of information it is necessary to take a series of images in several projections.

To diagnose fractures of the foot bones, the following projections are used:

Anteroposterior projection. The anteroposterior projection places the x-ray emitter in front of the foot and the film cassette in the back. This projection is an overview one, it is used in most cases on initial stage diagnostics
Lateral projection. The lateral projection assumes that the X-rays will pass through the foot area in one of the lateral directions. This allows you to better view some bones and their parts that are invisible in the direct anteroposterior projection.
Oblique projection. The oblique projection assumes that the axis formed by the X-ray emitter and the film will be located somewhat obliquely in relation to the lower leg, ankle joint and foot. The angle and side are selected depending on the expected pathology.
Projection oriented along the canal of the talus. The cassette with the film is placed under the foot, which is in a state of maximum plantar flexion. The X-ray machine is oriented so that the beam of X-rays passes at an angle of 15 degrees to the vertical line. This projection allows you to obtain the clearest image of the neck of the talus.
Broden's projection. To take a picture in this projection, it is necessary to place a film cassette under the foot in the position of external rotation. This position allows you to examine the articular surface of the calcaneus, which is especially useful during operations to compare bone fragments.

It should be noted that due to the large number of small bones, diagnosis and detection of fractures in this area is quite challenging. challenging task, the solution of which requires solid knowledge of anatomy and extensive clinical experience.

Signs of a fractured foot bones are:

change in the angle of the tuberosity of the calcaneus;
displacement of the articular surfaces of the calcaneus and talus relative to each other;
presence of a pathological fracture line;
identification of multiple bone fragments;
bone shortening;
change in bone shape;
the presence of darkening caused by the hammering of bone fragments into each other.

In addition to simple radiography, other methods can be used to diagnose a foot fracture, each of which has its own disadvantages and advantages. Usually to additional methods examinations are used when there is suspected damage to the neurovascular bundle, ligaments and tendons, when there are difficulties in the diagnostic process, as well as when a pathological fracture is suspected.
Computed tomography Computed tomography

is highly informative modern method research that allows you to detect even small defects in bones and some other tissues.

Computed tomography is indicated if a conventional x-ray examination turns out to be uninformative or if there is a suspicion of any concomitant pathological process.

This research method, like simple radiography, involves some exposure to radiation. Moreover, due to the longer duration of the procedure and the need to take a series of sequential images CT scan associated with large doses radiation than a simple x-ray.

Nuclear magnetic resonance Nuclear magnetic resonance

is a modern high-tech research method that is based on changing some properties of hydrogen atoms in a magnetic field. This method allows you to clearly visualize soft tissues and structures rich in water, which makes it extremely useful in diagnosing damage to nerves, blood vessels, ligaments, and soft tissues.

Due to the use of powerful magnets this method Contraindicated in the presence of any metal implants in the body of the subject.

Ultrasound examination (ultrasound)

Ultrasound examination has found wide application in medical practice due to its safety and simplicity. Ultrasound is based on the change in speed and reflection of sound waves at the boundary between two media.

Ultrasound is rarely used in trauma pathologies, since bone structures are impenetrable to sound waves. However, this method allows you to identify some signs of bone fracture, determine the inflammatory reaction, and also visualize accumulations of blood or other pathological fluid in the joint cavity.

First aid for suspected foot fractures Do you need to call an ambulance?

In most cases, a broken foot does not pose an immediate threat to a person's life. However, if timely and adequate measures are not taken to treat the fracture and compare bone fragments, serious complications and even disability.

Despite the fact that there is no threat to life, if you have a broken foot, you should immediately call an ambulance. This should be done for three reasons. Firstly, a foot fracture is accompanied by severe pain, which can rarely be relieved at home. Secondly, when a foot is fractured, the function of the entire limb is disrupted and the person loses the ability to move independently and, thus, is unable to independently reach the trauma center. Thirdly, a fracture of the bones of the foot may be accompanied by damage to nerves, blood vessels, or even fractures and injuries to other areas of the body, which requires thorough examination and diagnostics. In such cases, call an ambulance team, which can provide correct first aid and is capable of as soon as possible transported to a hospital department is not only justified and rational, but also a recommended action.

What is the best position to hold your leg?

In case of a fracture of the foot, in order to reduce the intensity of pain and reduce swelling of the limb, it is recommended to give the leg a slightly elevated position while waiting for an ambulance and transporting to the hospital. This will slightly increase blood flow and also reduce the static load on the bones of the foot.

However, in some cases, lifting your leg may make your foot pain worse. In such a situation, you should unload the foot as much as possible and give it a position in which the patient is most comfortable.

In no case should you try to set a fracture on your own, since without proper examination and qualifications this can lead to irreparable damage to nerves and blood vessels with the development of a number of serious complications.

Is immobilization necessary?

Limb immobilization, along with pain relief, is one of the key points when providing first aid. The main purpose of immobilization is not to compare bone fragments or restore bone integrity, but to immobilize the limb and unload it. This makes it possible to reduce the displacement of bone fragments during transportation, thereby reducing pain. In addition, this reduces the risk of damage to adjacent soft tissues.

To immobilize the foot, both special wire and wooden splints, which are supplied to ambulances, and ordinary sticks, boards, pieces of thick cardboard, plywood and other available materials can be used. Proper immobilization involves fixing the joints above and below the fracture site. In case of a fracture of the foot bones, the ankle joint and the foot itself should be fixed, thereby reducing its possible movements. It should be noted that if, after immobilization of the foot, the victim experiences increased pain, the fixing bandage and splint should be removed and the limb should be left free until the ambulance arrives.

Is it necessary to give painkillers?

Adequate pain relief is an extremely important component of first aid for a fracture. Unfortunately, most of the drugs available in everyday life have insufficient analgesic effect, so their use is not always effective.

The following drugs can be used for pain relief:

paracetamol tablets at a dose of 500 mg;
dexketoprofen tablets (Dexalgin) at a dose of 12.5 – 25 mg;
injections of dexketoprofen in a dose of 12.5 – 25 mg;
injections of analgin (revalgin) in a dose of 1 - 2 ml.

These drugs are capable of relieving mild to moderate pain, but in case of severe pain they only weaken, but do not eliminate, the unpleasant sensation of pain. Their mechanism of action is due to the ability to block special pro-inflammatory substances that are synthesized at the fracture site and are involved in the formation and transmission of pain impulses.

It should be noted that after taking

painkillers

in the form of tablets, you must wait about 20 - 30 minutes before the effect begins, since during this time the drug is absorbed from the gastrointestinal tract.

If possible, apply cold to the injured limb (

). This not only reduces swelling of the foot, but also significantly reduces the intensity of pain, and in addition, reduces bleeding and reduces the risk of complications. Ice should be applied to skin protected by several layers of fabric, as application to bare skin can cause

frostbite

The ambulance team arriving at the scene provides pain relief or

non-steroidal anti-inflammatory drugs

dexalgin, ibuprofen, diclofenac, analgin

), or narcotic drugs (

promedol, tramadol, morphine

). Narcotic painkillers have a much more pronounced effect and can relieve even severe pain. In addition, these drugs change emotional coloring and perception of pain, and reduce the threshold of excitability. However, due to a number of side effects, they are not recommended for use during long period time.

Treatment of fractured foot bones

The basis of treatment for fractures of the foot bones is the precise comparison of bone fragments and their fastening. If these conditions are met, a callus begins to form between the ends of the bone fragments, which hardens over time and covers the fracture site.

To compare bone fragments, two main methods can be used - open and closed. Closed comparison is used most often and involves the comparison of slightly displaced bone fragments with subsequent fixation with a plaster cast. Open comparison is carried out during surgery and involves careful comparison of bone fragments with fixation with screws, pins or plates.

Is it necessary to apply plaster?

If the bones of the foot are fractured, applying a cast is a mandatory procedure. A plaster cast is one of the ways to immobilize a limb during the period of formation and hardening of callus between bone fragments. In most cases, before applying a plaster cast, manual or instrumental reposition of bone fragments is performed.

The plaster cast is applied in such a way as to minimize possible movements at the fracture site and, at the same time, to relieve the limb as much as possible and bring the bones closer to their physiological position.

When the bones of the foot are fractured, plaster casts are usually used, which cover the entire foot and rise to the lower third of the lower leg. In most cases, to maintain the arch of the foot in a normal position during treatment, special insoles are used, which are placed in a plaster cast.

The time to wear a plaster cast depends on the location of the fracture, the degree of displacement of bone fragments, and the time of treatment. medical care, as well as from general condition the victim's body. On average, a plaster cast is applied for a period of 6 to 10 weeks.

When is surgery needed?

Surgical treatment for fractures of the bones of the foot is required when there is significant displacement of bone fragments, as well as when large quantities bone fragments. Typically, surgery is used in cases where other treatment methods are ineffective or impossible.

Surgical treatment involves dissection of the skin and soft tissue to access the bone structures. This procedure is performed under general or regional anesthesia (

depending on the general condition of the patient and the expected scope of the operation

During surgical treatment, a traumatologist, using sterile instruments, carefully compares bone fragments and fixes them with screws, metal plates or knitting needles.

Advantage surgical treatment there is a shorter recovery period, since after fixation of bone fragments, restoration motor function maybe pretty soon. However, it should be remembered that the injured limb should not be overloaded, and the range of motion must be restored gradually.

The speed of recovery after surgery depends on the following factors:

patient's age;
the presence of concomitant metabolic and hormonal disorders;
type of surgery;
physiotherapy.

It should be noted that a properly selected set of gymnastic exercises and physiotherapy allows you to restore the motor potential of the foot in the shortest possible time.
What physical procedures are indicated after a fracture?

Physiotherapy is a set of therapeutic measures, the use of which speeds up the process of fusion of bone fragments and helps reduce pain.

Physiotherapy prescribed for fractures of the foot bones

Type of procedure	Mechanism of therapeutic action	Duration of treatment
Exposure to ultra-high frequency electromagnetic fields	Changes the properties of a number of molecules and enzymes of cells, increasing the regenerative ability of tissues. Under the influence of the electromagnetic field, a warming effect occurs, which not only accelerates healing, but also reduces the inflammatory response.	The procedure can be prescribed starting 2–3 days after the fracture. To achieve a visible effect, 8–10 sessions are enough.
Low frequency pulsed magnetic therapy	It has a pronounced anti-inflammatory and analgesic effect, due to which the dose of painkillers can be reduced.	To achieve the desired effect, 8 to 10 half-hour sessions are required.
Ultraviolet irradiation of the fracture site	Ultraviolet light is necessary for the formation of vitamin D in the skin. This vitamin is involved in the processes of absorption and transformation of calcium, which is the main building material for bone tissue.	To normalize local metabolism, 3–4 sessions over 10–12 days are sufficient.
Electrophoresis with calcium preparations	Under the influence of constant electric current charged particles (calcium) are able to penetrate deep into tissues. Thanks to this effect, it is possible to achieve local enrichment of the fracture site with calcium and other minerals, which speeds up the healing process of bone fragments.	Can be prescribed daily for one to two weeks.

The anatomy of the bones of the foot almost repeats the hand and consists of the following elements:

tarsals;
heel and instep;
five plus feet;
14 phalanges of fingers (2 for the first, but 3 for the others).

Nevertheless, the task of the foot, unlike the hand, is not grasping, but mainly supporting, and this is reflected in its structure.

The bones are rigidly connected to each other and have an elastic dome-shaped structure, which is preserved due to their special shape, as well as muscles and ligaments. The plantar ligaments tighten the edges of the foot from below, forcing it to arch upward in the form of an arch. This structure makes the foot a spring shock absorber, absorbing pressure surges during movement that act on the legs and spine.

Description of components

The skeleton of the foot has 52 bones. The joints are small and have a rather complex structure. The ankle connects the foot to the lower leg, and the small bones of the lower leg are also connected by small joints.

The bases of the phalanges of the fingers and 5 metatarsal bones are fastened by joints of the same name. And each finger consists of 2 interphalangeal joints that hold together the small bones. The tarsals are connected to the central frame of the foot by the metatarsal and tarsal joints. They are secured with a long ligament of the sole, which prevents the occurrence of flat feet. The bones of the human foot consist of three parts: the tarsus, metatarsus and toes. The composition of the tarsus: behind it is formed by the talus and calcaneus, and in front by the scaphoid, cuboid and three sphenoid bones. The talus is placed between the shin bone and the calcaneus, playing the role of an adapter from the lower leg to the foot. Along with the talocaleonavicular joint, the joint connects the tarsus and the posterior part. With their help, the possibilities of foot movement increase to 55 degrees.

Movement of the foot relative to the lower leg is provided by two joints:

The ankle joint itself is formed by two tibia and talus bones. It allows you to raise and lower the forefoot.
The subtalar joint is located between the talus and calcaneus bones. It is necessary for bending from side to side.

A common injury is an ankle sprain, which occurs when the leg twists when a person makes a sudden change of movement or on an uneven surface. Usually the ligaments on the outside of the foot are injured.

The calcaneus belongs to the posterior lower part of the tarsus. It has a long configuration, flattened at the edges and is the most impressive in size in comparison with others and consists of a body and a tubercle of the calcaneus protruding backwards. The heel has the joints necessary to fit into the talus above and into the cuboid in front. Inside the heel bone there is a protrusion that serves as a support for the talus.

The navicular bone is located at the inner edge of the foot. It has joints that connect to the bones adjacent to it.

The cuboid bone is located at the outer edge and connects posteriorly with the calcaneus, internally with the navicular, externally with the sphenoid, and in front with the 4th and 5th metatarsals.

The toes are built from phalanges. Similar to the structure of the hand, the thumb is built from two phalanges, and the remaining fingers are made from three.

The phalanges are divided:

proximal,
average,
distal.

The phalanges of the foot are much shorter than the phalanges of the hand, especially the distal phalanges. It cannot compare with the hand in mobility, but its arched structure makes it an excellent shock absorber, softening the impact of the foot on the ground. The ankle of the leg has a structure that provides the mobility necessary when walking or running.

Every movement of the foot is a complex interaction of muscles, bones and joints. Signals sent by the brain coordinate the work of the muscles, and their contraction pulls the bone in a specific direction. This causes the foot to flex, extend, or rotate. Thanks to the coordinated work of the muscles in the joint, movement of the joint in two planes is permissible. In the frontal plane, the ankle does extension and flexion. IN vertical axis Rotation can be performed: slightly outward and inward.

Over the course of a lifetime, each sole hits the ground an average of more than 10 million times. With each step a person takes, a force acts on the knee, often 5-6 times greater than the weight of his body. When he steps on the ground, the anterior calf muscles pull on the tendons attached to the top of the foot and lift it along with the toes. The heel takes the blow first. As the entire foot lands on the ground, the tarsal bones form a springy arch, distributing the load of the body's weight as its pressure moves from the heel to the anterior end of the metatarsus and toes. The posterior calf muscles pull on the Achilles tendon, which lifts the heel off the ground. At the same time, the muscles of the foot and toes contract, moving them down and back, resulting in a push.

Problematic issues and diseases, from calluses to arthritis, are dealt with by a podiatrist - a specialist in the treatment of feet. It also helps correct posture and gait. You can learn about everything that happens to the feet from this specialist: hygiene care, selection of optimal shoes, fungal diseases, heel pain, arthritis, vascular problems, as well as calluses, bunions and ingrown nails.

The podiatrist is also knowledgeable about the mechanics of leg movement. For example, if one of the two feet is more flattened than the second, there is an imbalance in the body, which is reflected hip pain, and inflexibility of the big toe can affect the functioning of the spine.

What role do cartilages play?

When studying the bone structure of the leg, you need to pay attention to the cartilage. Thanks to them, joints are protected from excessive stress and friction. Their articulated ends are covered with cartilage with a very smooth surface, which reduces friction between them and absorbs shock, thereby protecting the joint from damage and wear. The cartilage-covered heads of bones glide because they are elastic, and the synovial fluid produced by their membrane is a lubricant that keeps joints healthy. A deficiency of synovial fluid can limit a person's ability to move. Sometimes cartilage can also harden. In this case, the movement of the joint is greatly impaired, and bone fusion begins. This phenomenon cannot be ignored, otherwise you may lose mobility in the joints.

The Achilles or heel tendon is the longest and strongest tendon in the human body. It connects the lower end of the gastrocnemius and soleus muscles with the posterior tubercle of the calcaneus. As a result, the contraction of these muscles pulls the heel up, allowing you to stand on the toe of your foot and push it off the ground when moving.

Characteristic diseases

Like any part of the body, the bones of the foot are subject not only to external influences; its condition is affected by a person’s age, when bone structure becomes less strong, and the joints are not as mobile. Let's look at the most common foot problems.

Bunion of the big toe.

We are talking about inflammation of the bursa in the metatarsus of the phalangeal joint of the first toe. Women suffer from this disease more often than men, the reason is narrow high-heeled shoes, which create high blood pressure on your toes. This leads to the development of other problems such as calluses and corns. Pain and discomfort can be relieved by wearing comfortable, roomy shoes and using soft padding on the bunion to protect it from pressure. In advanced cases, surgery is recommended.

Hallux valgus deformity.

The disease is manifested by bulging to the side of the metatarsus of the phalangeal joint of this finger, which deviates in the opposite direction. Often, but not always, it leads to bursitis and the formation of a lump. Sometimes this problem is passed down through generations and develops in youth. If such deformation appears only in old age, it is often caused by incipient osteoarthritis.

Flat feet.

Flat feet is a thickening of the arch of the foot. Normally, its inner side between the heel and metacarpophalangeal joints is curved upward. If it is not expressed, flat feet are observed. This disease occurs in approximately 20% of the adult population. Often no treatment is required. We only recommend comfortable shoes with a special insole or arch support under the arch of the foot. For older people, special orthopedic shoes are ordered. And only in the most severe cases, foot deformity is corrected surgically.

Deforming arthrosis.

The disease occurs due to calcium deficiency, injuries, increased stress, and thinning of cartilage tissue and bone tissue. Over time, growths appear - osteophytes, which limit the range of movements. The disease is expressed by severe mechanical pain, which intensifies in the evening, subsides with rest and increases with physical activity. You can slow the progression of these diseases and reduce their symptoms different ways. These include reducing stress on the affected joint and keeping it active. Shoes should be comfortable, fit well, provide excellent arch support, minimizing vibration when moving.

People should take care of their health. Take small steps that will lead to healing and maintaining bone strength and joint mobility, using moderate physical activity, relaxing massages or various physiotherapeutic procedures. And then your health will not let you down and will allow you to maintain an active and active lifestyle in your older years.