In this condition, the foot takes on the shape of a sickle. The forefoot turns inwards and the toes are strongly bent inwards. Doctors refer to this as an adduction position (adduction means pulling towards the body). The metatarsophalangeal joint of the big toe is also often bent inwards.
This malposition often occurs on both feet, but is usually painless. The affected children can usually move normally. However, small children with a sickle foot may have problems learning to walk as they turn their feet and legs inwards. This can lead to orthopaedic problems.
The cause of this foot malposition can be traced back to pregnancy. However, in most cases it regulates itself. If this is not the case, there are various treatment methods that are promising.
Sickle foot usually develops in babies in the womb. One of the main causes is a lack of space. The womb (uterus) is relatively narrow - in some cases this causes the unborn child to adopt a forced position. This sometimes leads to the foot buckling.
This explains why many children already show foot malposition at birth. Premature babies are only very rarely affected by sickle foot for this reason: they leave the womb before such a lack of space occurs.
Sometimes too tight: the baby in the womb © poco_bw / Fotolia
Other causes of sickle foot are
- genetic factors (if both parents carry the hereditary traits for it),
- the baby often lies in a prone position,
- shortened muscles on the inner foot.
If babies or toddlers often lie on their stomachs, the feet are spread out unfavorably.
The toes rest on the floor, causing the front feet to bend inwards. In some cases, this results in a sickle foot after birth.
The foot deformity usually disappears by itself in the course of early development. If this is not the case and the sickle foot is not treated, further consequences are possible.
In addition to problems with learning to walk or an altered gait pattern, the following effects may occur:
- the metatarsus stiffens due to the malposition
- the incorrect load leads to pressure points (e.g. on the knee joint)
- early degradation of cartilage and damage to the bones(osteoarthritis) is possible
- especially in adults: Pain when walking, pressure points
Sickle foot in small children is generally diagnosed during a general examination by the doctor. In babies, the pediatrician already becomes aware of the malposition of the feet during the obligatory U-examinations. Typical symptoms such as the bent metatarsus and the bent big toe are usually sufficient for a visual diagnosis.
In small children, the typical gait pattern with feet and legs turned inwards provides a reliable indication that a sickle foot is present.
The doctor also has the option of clarifying the exact extent of the disease with the help of an X-ray .
Orthopaedists also test whether the sickle foot can be passively corrected. To do this, they hold the back of the foot and slowly move the entire foot into the normal position. This test gives the doctor an indication of the best further treatment.
In many cases , the sickle foot disappears by itself over time. In around 80 to 90 percent of patients, comprehensive treatment is therefore not necessary. However, parents should take a few tips to heart to support their children:
© PhotographyByMK / Fotolia
- Manual correction: always bring the foot back into the normal position using your hands
- gently stroke the edge of the foot with your finger - the foot will often return to its physiological (i.e. normal) position by itself
- Foot massages, for example regularly when wrapping
- if your feet are warm, gently stimulate them with ice cubes
- Do not lay babies on their stomachs for too long or too often
- Place foam rings around the legs when lying on the stomach
Foam rings are simply placed around the thighs when the baby is lying on its tummy. On the one hand, this is a way of helping the sickle foot to heal. But it is also a precautionary measure: parents can prevent sickle foot from developing in healthy babies in the first place.
If the deformity does not correct itself over time, various therapies can be considered. One of these is corrective plaster casts, which the doctor applies to the thighs for a few weeks. Babies are then given so-called positioning shells, which only correct the foot at night.
Toddlers who are already walking are given supportive insoles for their shoes. These support the heels and have a raised inner edge that compensates for the malposition. Physiotherapy and physiotherapy are also useful. They stabilize the foot and strengthen the muscles.
The doctor rarely advises surgery. Doctors try to avoid this option, especially for babies. However, if other therapeutic measures are ineffective, surgery is a reliable treatment method. One option is to cut the attachment tendon in the big toe. The surgeon also has the option of removing joint capsules throughout the foot to make it easier to align correctly. The foot is then stabilized with wires.
In adults, the doctor usually removes parts of the bone in an operation. This gives them the opportunity to influence the position of the foot and achieve normal alignment.
Sickle feet therefore occur in children and adults - although the deformity usually corrects itself in the course of earlier development. Parents have many options to support this self-healing process: Foot massages, targeted stimuli and increased supine or lateral positioning are important tips to follow. If the misalignment does not correct itself, various therapeutic approaches can be considered. From physiotherapy and medical aids to surgery, there are many good options. It is important to take advantage of these: If a sickle foot remains untreated over a long period of time, it usually leads to further damage.