扁平足—國家徵兵體檢被淘汰原因之一!國家良苦用心看這篇就知道

前一段時間,我朋友的弟弟響應國家號召,踴躍報名參軍入伍,把自己的愛國之心化為報國之行。但是就在徵兵體檢的時候,因為被檢查出扁平足而失去了投身軍營的機會。朋友很不解的打電話問我,為什麼扁平足會影響當兵呢?平時我弟弟日常生活一切正常,也沒有什麼不舒服的症狀啊。今天我們就來說一說扁平足,看完這篇大家就能知道國家的良苦用心了。而且很多愛美的女性因為扁平足無法穿高跟鞋。

扁平足—國家徵兵體檢被淘汰原因之一!國家良苦用心看這篇就知道

什麼是扁平足?

平足症(flat foot)俗稱扁平足,是指內側足弓低平或者消失,同時伴有足部畸形、跟腱短縮等。患足失去彈性,在站立和行走時足弓塌陷,出現疲乏或疼痛的症狀。平足症是最常見的足部疾病之一,通常分為姿態性平足症和僵硬性平足症兩種。

扁平足—國家徵兵體檢被淘汰原因之一!國家良苦用心看這篇就知道

要想了解平足症,首先要知道足部的相關解剖知識。

足部除了負重意外,還要適應行走、跑、跳等動作,保持人體的平衡穩定,因此足既是一個強有力的支撐結構,又具有能屈曲活動的功能。想必大家對於足弓的概念多多少少有點了解,我們所說的足弓簡單點來說就是:足的結構像是一張弓。足部的骨骼組成弓臂,足底的蹠筋膜構成弓弦。足弓由足縱弓和橫弓構成。足弓降低或者消失後,在負重時,足部承受身體衝擊力的功能就減弱或者消失。

扁平足—國家徵兵體檢被淘汰原因之一!國家良苦用心看這篇就知道

平足症的病因有哪些?

平足症可由先天性或者繼發性因素髮病。先天性因素指的是足部骨骼、韌帶或者肌肉的發育異常,包括:1.跟骨外翻畸形2.垂直距骨3.足舟骨結節過大4.兒童骨骺未融合或者有副足舟骨5.先天性足部韌帶、肌肉鬆弛等,均可導致扁平足。繼發因素包括:1.長久站立或者負重,使得維持足弓的韌帶疲勞而逐漸衰弱2.慢性疾病或身體過重,缺乏適當鍛鍊,小腿和足部肌肉萎縮,不能維持足弓張力3.女性高跟鞋等穿鞋不適,導致足部過度前傾,縱弓遭到破壞4.足部骨病如類風溼性關節炎、骨結核等5.足部肌肉肌力失去平衡。

扁平足—國家徵兵體檢被淘汰原因之一!國家良苦用心看這篇就知道

平足症的病理改變有哪些呢?

根據平足症的軟組織改變的程度不同,可分為易變性即姿態性平足症和僵硬性即痙攣性平足症,後者常合併腓骨肌痙攣。易變性平足症比較常見,軟組織雖然鬆弛,但仍然保持一定彈性,負重時足扁平,除去承重力,足弓可以恢復正常,長期治療效果滿意。僵硬性平足症多數由於足部骨骼及軟組織等多種病變所致,不易矯正,平足症狀不會隨著負重的消失而得到緩解。

扁平足—國家徵兵體檢被淘汰原因之一!國家良苦用心看這篇就知道

平足症的臨床表現有哪些?

稍久戰或行走1-1.5km就可引起足部痠痛,足抬起後疼痛減輕或者消失,嚴重者行走時步態蹣跚,行走遲緩,全足著地,不敢提足跟,容易出現足部疲勞和疼痛,也可以伴有八字步態。痙攣性平足症病人有腓骨肌疼痛,僵直。查體時可以發現足腰部腫脹,足印肥大,全足寬闊、低平,跟舟韌帶部壓痛。X線片足側位片顯示足弓塌陷,骨骼之間關係失常。嚴重的平足症患者還會出現跗骨關節炎和骨質症狀等。所以對於士兵來說,平足症的人群無法耐受長途跋涉,所以我國對於新兵入伍體檢時,將嚴重的平足症作為體檢不合格的標準。

1. 對於輕型的患者,可採用非手術治療方案,在活動時糾正足的平衡,進行足部訓練,加強脛骨前肌和脛骨後肌的肌力,矯正足外翻。在行走時,應穿足底和足跟內側加高3-6cm的矯形鞋墊,鞋後跟應寬,鞋底內側應直平,鞋腰部應窄,並經常練習用足趾行走,做屈趾活動。

扁平足—國家徵兵體檢被淘汰原因之一!國家良苦用心看這篇就知道

2. 極少數姿態性病人需要手術治療,但是痙攣性扁平足經常因為嚴重的症狀而需要手術治療。痙攣性扁平足若病程短,可以首先選用手法做被動鍛鍊,逐漸克服肌肉的痙攣,或者在麻醉下使用內翻手法矯正畸形後,以石膏靴固定,5-6周後拆除時高改穿平足矯形鞋。對合併骨關節炎、骨性畸形的成年病例,需要施行手術治療。手術方法有好幾種。嚴重的痙攣性扁平足,必要時可以實行關節融合術。

總結與推薦:

1. 平足症(flat foot)俗稱扁平足,是指內側足弓低平或者消失,同時伴有足部畸形、跟腱短縮等。患足失去彈性,在站立和行走時足弓塌陷,出現疲乏或疼痛的症狀。平足症是最常見的足部疾病之一,通常分為姿態性平足症和僵硬性平足症兩種。

2. 足既是一個強有力的支撐結構,又具有能屈曲活動的功能。足的結構像是一張弓。足部的骨骼組成弓臂,足底的蹠筋膜構成弓弦。足弓由足縱弓和橫弓構成。足弓降低或者消失後,在負重時,足部承受身體衝擊力的功能就減弱或者消失。

3. 平足症可由先天性或者繼發性因素髮病。

4. 根據平足症的軟組織改變的程度不同,可分為易變性即姿態性平足症和僵硬性即痙攣性平足症,後者常合併腓骨肌痙攣。

5. 稍久戰或行走1-1.5km就可引起足部痠痛,足抬起後疼痛減輕或者消失,嚴重者行走時步態蹣跚,行走遲緩,全足著地,不敢提足跟,容易出現足部疲勞和疼痛,也可以伴有八字步態。痙攣性平足症病人有腓骨肌疼痛,僵直。

6. 對於輕型的患者,可採用非手術治療方案,在活動時糾正足的平衡,進行足部訓練,加強脛骨前肌和脛骨後肌的肌力,矯正足外翻。極少數姿態性病人需要手術治療,但是痙攣性扁平足經常因為嚴重的症狀而需要手術治療。

感謝您的閱讀,如果您認為我的科普對您有所幫助,動動小手點個贊和關注。如果您對平足症有疑問也可以留言,共同討論。如果大家想了解哪一個疾病,也可以留言告訴我。您的關注,是我奮勇前行的動力!


參考文獻:
1. Menz HB, Dufour AB, Casey VA, et al. Foot pain and mobility limitations in older adults: the Framingham Foot Study. J Gerontol A Biol Sci Med Sci 2013; 68:1281.
2. Clawson DK, Jackson DW, Ostergaard DJ. It's past time to reform the musculoskeletal curriculum. Acad Med 2001; 76:709.
3. Dunn JE, Link CL, Felson DT, et al. Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. Am J Epidemiol 2004; 159:491.

4. Thomas MJ, Roddy E, Zhang W, et al. The population prevalence of foot and ankle pain in middle and old age: a systematic review. Pain 2011; 152:2870.
5. Menz HB, Tiedemann A, Kwan MM, et al. Foot pain in community-dwelling older people: an evaluation of the Manchester Foot Pain and Disability Index. Rheumatology (Oxford) 2006; 45:863.
6. O'Kane JW, Levy MR, Pietila KE, et al. Survey of injuries in Seattle area levels 4 to 10 female club gymnasts. Clin J Sport Med 2011; 21:486.
7. Pearce CJ, Brooks JH, Kemp SP, Calder JD. The epidemiology of foot injuries in professional rugby union players. Foot Ankle Surg 2011; 17:113.
8. Kaplan LD, Jost PW, Honkamp N, et al. Incidence and variance of foot and ankle injuries in elite college football players. Am J Orthop (Belle Mead NJ) 2011; 40:40.
9. Campoy FA, Coelho LR, Bastos FN, et al. Investigation of risk factors and characteristics of dance injuries. Clin J Sport Med 2011; 21:493.
10. Nwawka OK, Hayashi D, Diaz LE, et al. Sesamoids and accessory ossicles of the foot: anatomical variability and related pathology. Insights Imaging 2013; 4:581.
11. Cass AD, Camasta CA. A review of tarsal coalition and pes planovalgus: clinical examination, diagnostic imaging, and surgical planning. J Foot Ankle Surg 2010; 49:274.
12. Giuffra V, Bianucci R, Milanese M, et al. A case of brachymetatarsia from medieval Sardinia (Italy). Anat Rec (Hoboken) 2014; 297:650.
13. Robinson JF, Ouzounian TJ. Brachymetatarsia: congenitally short third and fourth metatarsals treated by distraction lengthening--a case report and literature summary. Foot Ankle Int 1998; 19:713.
14. Froehlich V, Wuenschel M. A rare combination of brachymetatarsia and congenital hallux varus: case report and review of the literature. J Am Podiatr Med Assoc 2014; 104:85.
15. Jenkins DW, Cooper K, O'Connor R, et al. Prevalence of podiatric conditions seen in Special Olympics athletes: Structural, biomechanical and dermatological findings. Foot (Edinb) 2011; 21:15.
16. Hillstrom HJ, Song J, Kraszewski AP, et al. Foot type biomechanics part 1: structure and function of the asymptomatic foot. Gait Posture 2013; 37:445.
17. Mootanah R, Song J, Lenhoff MW, et al. Foot Type Biomechanics Part 2: are structure and anthropometrics related to function? Gait Posture 2013; 37:452.
18. Di Caprio F, Buda R, Mosca M, et al. Foot and lower limb diseases in runners: assessment of risk factors. J Sports Sci Med 2010; 9:587.
19. Rouvreau P, Pouliquen JC, Langlais J, et al. [Synostosis and tarsal coalitions in children. A study of 68 cases in 47 patients]. Rev Chir Orthop Reparatrice Appar Mot 1994; 80:252.
20. Galica AM, Hagedorn TJ, Dufour AB, et al. Hallux valgus and plantar pressure loading: the Framingham foot study. J Foot Ankle Res 2013; 6:42.
21. Hopson MM, McPoil TG, Cornwall MW. Motion of the first metatarsophalangeal joint. Reliability and validity of four measurement techniques. J Am Podiatr Med Assoc 1995; 85:198.
22. Nawoczenski DA, Baumhauer JF, Umberger BR. Relationship between clinical measurements and motion of the first metatarsophalangeal joint during gait. J Bone Joint Surg Am 1999; 81:370.
23. Coughlin MJ, Shurnas PS. Hallux rigidus: demographics, etiology, and radiographic assessment. Foot Ankle Int 2003; 24:731.
24. Grady JF, Axe TM, Zager EJ, Sheldon LA. A retrospective analysis of 772 patients with hallux limitus. J Am Podiatr Med Assoc 2002; 92:102.
25. Coughlin MJ, Shurnas PS. Hallux rigidus. Grading and long-term results of operative treatment. J Bone Joint Surg Am 2003; 85-A:2072.
26. McCormick JJ, Anderson RB. Turf toe: anatomy, diagnosis, and treatment. Sports Health 2010; 2:487.
27. George E, Harris AH, Dragoo JL, Hunt KJ. Incidence and risk factors for turf toe injuries in intercollegiate football: data from the national collegiate athletic association injury surveillance system. Foot Ankle Int 2014; 35:108.
28. Espinosa N, Brodsky JW, Maceira E. Metatarsalgia. J Am Acad Orthop Surg 2010; 18:474.
29. DiPreta JA. Metatarsalgia, lesser toe deformities, and associated disorders of the forefoot. Med Clin North Am 2014; 98:233.
30. Schuh R, Seegmueller J, Wanivenhaus AH, et al. Comparison of plantar-pressure distribution and clinical impact of anatomically shaped sandals, off-the-shelf sandals and normal walking shoes in patients with central metatarsalgia. Int Orthop 2014; 38:2281.


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