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Duz Flat insoles up to the age of 5 and normal pressing basma

Orthopedics and Traumatology Specialist stated that flat footing should be evaluated as a result of normal development process in children until the age of 5 years. Dr. Mithat Oner said that there is no need to use a special insoles or shoes before this age.

Orthopedics and Traumatology Specialist Dr. Mithat Oner, until the age of 5 scientifically "flat insoles" can not be diagnosed, continuing after this age of flat insoles should be treated, he added. Stating that families' intense concerns about the flat insoles of their children at this age, it leads to abuse such as the sale of special insoles and special shoes. Dr. Öner continued his words as follows:

No need for special insoles and shoes
Kadar It should be known that almost all children up to the age of five have a flat base. This is a scientific fact. The sole of the foot anatomically completes itself at the end of the 4th year. So there is no need to worry early. This issue is very vulnerable to abuse. Recently, sales of special insoles or special shoes are made under foot scans, which go down to kindergartens. Children are examined and situations that cause families to be worried are revealed. Care must be taken against this. Because it is not possible for children to be diagnosed with a flat base before the age of five. 5

Professor Öner advised children before the age of 5 to walk barefoot at home and to wear only soft shoes outside without the need for extra features.

Children after the age of 8, two feet stuck together each other, pain and prevent the sport should be started in situations that prevent treatment. Dr. Öner, ’85 percent of flat insoles are flat insoles that do not require treatment and do not cause problems in the daily life of the child. The remaining 15 percent are conditions that are an underlying disease, such as congenital bone deficiency or excess, which the orthopedic surgeon should intervene. They will be best treated by orthopedic surgeons. The 8-12 age range is the age range that responds best to the treatment. I


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Flat insoles are not fate!

Foot and Ankle Surgery Specialist Dr. Tahir Öğüt stated that flatfoots with pain and past stage should be corrected by surgery, and if the operation is performed on time, it is possible to correct the flatfoot without fixing the joints.

Nobody wants to be called a flatfoot. If you're flatfooted, you're either black-lucked or blind-lucky. Neither your business goes random, nor does it laugh at you. Although rumors continue like this, flatfoot is not fate. Liv HOSPITAL Foot and Ankle Surgery Specialist from Orthopedics and Traumatology Department. Dr. Tahir Öğüt gives information about the flatfoot.
What kind of complaints does flat footbed cause?

We can roughly evaluate flatness in two separate groups. One is flatfoot, which is present since childhood, and the other is the development of flatfoot in a person called '' adult type '' whose feet are normal as a child.

· The foot gradually deforms over time. This is a progressive condition and the rate of progression varies from person to person, depending on usage and genetic structure.

· The pit on the inside of the foot starts to collapse, the toenail of the toe is looking at the ceiling before it is looking at the other foot, the heel starts to slide out slowly. As the deformity increases, a protrusion begins to form on the mid-inner side of the foot.

· A person cannot stand up or have difficulty getting up on one foot.

· Pain in the middle-inner side of the foot at first, but later in the foot pain in the outside. In short, pain and deformity are the main symptoms of flatfoot.

· Deformation occurs in shoes.

Mistakes

Unfortunately, when such a patient is admitted to a doctor, MRI is often required for examination. The patient wanders around the doctor with MRI scans under the chair and is told that he should usually use only a pair of insoles. Even if the patient is a child, special shoes are recommended and families are satisfied. However, normal foot X-rays taken while standing are sufficient to diagnose and determine the degree of flatfoot. MRI is extremely unnecessary. Special shoes have no place in the treatment of flatfoot.

How should it be treated?

First of all, an orthopedist experienced in foot care should be consulted. Treatment is based on the degree of flatfoot. In the first stage, insoles may be used. Insoles do not relieve flatness but can relieve pain and reduce progression. The insoles used must be personal. Unfortunately, it is very rare for patients to see a doctor at the initial stage and to make a correct diagnosis even if they do. Once this stage has passed and foot deformity begins to occur, the soles do not help much. Flatfoot with pain and past stage should be corrected by surgery. If the operation is performed in a timely manner, it is possible to correct the flatness without fixing the joints, but in delayed cases, the only remedy is to fix (freeze) the joints. Flatfoot surgery gives patients a better quality of life.

When does the patient return to normal life after surgery?

This depends on the age, stage and technique of surgery. While the patient can step in one to two weeks in the screwing technique used in special cases in children, the foot is usually held in half plaster, which we call splint, for 6 weeks after other methods we use more. You can walk with the aid of a walker or crutch by pressing the intact side within 6 weeks, but the surgical foot is not pressed for 6 weeks. The transition to normal shoes is between 6 and 10 weeks, depending on the technique used.

What are the complications of surgery?

The most unpleasant part of these surgeries is to be able to stand up immediately after the operation, which is normal. Because people walk on their feet, and if a foot is not fully healed, complications can occur. Apart from that, the risk of complications is negligible when performed by an experienced foot surgeon. If we do not take care of our feet, our quality of life will deteriorate and our life will be affected by our feet.

Causes of flatfoot in adults

Excess weight

Old and untreated old foot and heel fractures

Abuse: Unsuitable footwear, excessive strain, trauma

Rheumatologic diseases

Diabetes


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Shoe insoles must be the same as foot size

Professor Dr. Mehmet Halıcı said that the external insoles used for the comfort of the shoes should be the same as the foot number in order to be functional.
According to the daily activities of those who have to wear shoes that are not very suitable for foot orthopedics such as sneakers or boots, they can make their shoes comfortable with external insoles. Dr. Carpet, gave information about the issues to be considered when buying insoles. First of all, Prof. insists that the insoles should be the same as the foot number. Dr. Halıcı said, büyük One of the biggest mistakes when purchasing these insoles is; removing insoles that do not correspond to the foot number. If the insoles are shifted inside the shoe, it can become a grind rather than a solution to the patient's problems. Therefore, the insoles must be large enough to grasp the shoes. In addition, the use of insoles, normal shoe size half or a number of large shoes to buy another important issue, ”he said.

Selection of insoles should be made according to the purpose
There are two types of external insoles, including half and full. Dr. Halıcı, pointed out that the purpose of using both soles are different from each other. He pointed out that half-soles were used for heel elevation or to relieve the feet of patients with heel spurs. Dr. Halıcı said, “We also use full soles to support the foot arch or arch and increase foot comfort, especially for people with flat soles or people with daily activity with traditional shoes. Therefore, a wide variety of insoles are sold in the market. However, when purchasing them, attention should be paid to the purpose of being used as well as being of good quality ”.


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Flat Insoles

When our feet are evaluated in terms of movement of our body, they are located in important anatomical structures such as our knees and hip joints. It is imperative that we have healthy feet so that we can walk upright with a load on both feet.
One of the most important tasks of the foot is to help the body's load-bearing ability and to perform the walking task. The feet make a stretching movement from the heel to the front of the foot during the step-by-step movement. In this way, they help the body's spring mechanism and allow us to carry our load and walk. The most important area that provides this spring movement in the legs, which allows us to walk and survive painless and long term, is the inner curve (arc) located on the inner side of both legs and which prevents the collapse of the foot when it hits the ground. This inner curve consists of bones supporting the inner surface of the foot, as well as ligaments and muscles that hold these bones together. Like the meniscus on the knee, this inner curve flexes during load to help distribute the weight evenly and evenly to the ground.

What is flat footed?
The absence of this inner curvature, which is one of the most basic structures for walking, is mentioned as flat insoles. In these people, when the feet step on the ground, the inner arch of the foot collapses, unable to bear the weight of the body and causes the foot to become flat. For this reason, this is called flat insoles. Since the load to be transferred from the heel to the front cannot be transferred properly, a balanced load distribution cannot occur at the soles of the feet and in patients, especially after long-term walking, heavy load carrying, long-term standing and sporting activities, various pain, burning, stinging, drowsiness, painful burning, and stinging accompanied by drowsiness.
The most common finding that accompanies flatfoot is stepping in while walking. The deterioration of the load carrying capacity of the foot causes the load to be loaded on the inside of the foot structure and thus the problem of stepping in the foot occurs. This base collapse will not cause any symptoms and discomfort in some cases or diseases, or in some cases it may create some specific complaints and signs. Among these complaints, standing and pain are the most common complaints. Standing pain is usually reflected in the knee, hip and waist. Stiffness may occur in the calf muscles. There may be limitations in ankle joint movements. Calluses on the soles of the feet may occur due to these restrictions due to the regression of the Achilles tendon adhering to the heel. The heel bone can lie outward and cause early wear on the inside of the shoe claw and on the heel. In addition to all these findings, other findings include increased pain with gait, shin bone pain in the evening, especially at night, triggering of lumbar problems that present previously and occasionally cause pain, early fatigue and decreased sporting activity performance. In summary:

• If your feet get fatigued quickly and you have pain in your leg that is increasingly spreading through prolonged standing,
• Pain develops around the heel, and stiffness and contraction occurs in the calf muscles,
• If the pain in your feet starts to hinder your sporting activities,
• If the inner claws of the shoes wear out prematurely and you have weakness in your feet, it will be useful to consult your physician for evaluation of flat soles.

Are there any types of flat soles, if any?
While describing the flatfoot problem, it is essential to evaluate in two different groups, although there are basically many different subtypes.
• The first type, and much more common flat footbed, is the type we call flexible flat footbed. Flexible flat insoles, which are usually diagnosed in childhood, have only loosening and excessive flexibility in the ligaments and muscles without any bone problems. In this table, when the patient's foot does not touch the ground, a curvature is present in the inner region of the foot, but this curve disappears by stepping on the ground and the feet collapse inward. The most important factor in the diagnosis of soft flat soles is to see if the inner arch of the foot is formed when the patient rises at the fingertips. This is an indication for soft flat insoles if a curvature is formed on the inside of the foot when it is raised at the toes.

• The second type of flat foot is a more rigid flat foot which is more rare and usually requires further examination and treatment. In this type, the foot of the patient stands firmly and flatly both during the stepping down and when not touching the ground. When the foot is on the ground, the ankle and heel are bent outwards and the foot is bent inwards, as the foot has no inner curvature. In these patients, as opposed to the flexible flat soles, the shape of the foot does not change and an inner curve does not occur when the finger tip is raised. This type of flat insoles, which is one of the heavy forms of flatfoot, can occur for many different reasons such as congenital or developmental and requires detailed examination by a specialist physician.
Although there are many different shapes and types and acquired type flat insoles after traumas or accompanying sugar or rheumatic diseases, flat insoles described above are most commonly seen. Considering the flatbed as a double-ended fan, this range includes a flexible flatbed, the lightest form at one end, and a hard flatbed, the heaviest form at the other. When you consult your physician, you can find answers to the questions about whether there is any flat insoles, if there is any flat foot, anteroposterior and lateral radiographs to be taken after the physical examination. Advanced imaging modalities such as tomography or magnetic resonance imaging are rarely needed for the diagnosis of flat footing, and an outpatient diagnosis can be made on the same day.

What are the treatment options for flat insoles?
There is no need for treatment if the person with a flat sole does not have any pain, or if there is no fatigue or difficulty in standing, which affects his or her social life, and especially if the flat sole is a flexible flat sole. In other words, the main consideration in treatment planning is the complaints in the patient. In general, these patients complain that their feet step inward while walking with aesthetic concerns. It is sufficient to inform these patients with the necessary recommendations and to warn them about the course of flat footing. There is no need for any physical therapy or special insoles.
In patients who have pain during walking or who start to have pain with long-term social activity and get tired quickly, treatment is required regardless of the type of flatfoot. These patients have a wide range of options ranging from simple life change recommendations to surgical treatment options. Apart from the surgical treatment option, the following should be done:

• Shoe changing (shoe modification), wide selection of soft soles,
• Use of silicone or custom made insoles or orthotics supporting the inner arch of the foot,
• Use of drugs that relieve pain and prevent tissue reaction due to flat soles,
• Steroids and analgesic needle treatments to the ligament of the stretched inner arch due to flat soles to reduce pain,
• Resting and applying cold compress (ice) treatment,
• There are physical therapy options (exercises supporting the inner arch of the foot).

Surgical treatment may be necessary, especially in patients with a stiff flat base that do not respond to the non-surgical treatment options outlined above. Surgical methods used; The aim is to relieve the pain and to re-establish the bone alignment to bring the inner arch of the foot into a load-bearing shape. Physicians interested in foot flat soles and surgery are orthopedic specialists. You should discuss with your orthopedic doctor to decide which surgery should be performed and to discuss with you the possible risks before and after surgery and how to undergo a post-operative rehabilitation process.


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Wait in the evening to get shoes because ...

Which diseases indicate pain in the foot? What does the personalized insole do? What to do with flat base?

Which type of sport should be directed to children in which structure? Why shouldn't children be dressed until they are 18 months old, and what problems can personalized insoles have to overcome? Here are the remarkable titles of this part of our article series and the answers of the expert ...

Orthopedics and Traumatology Specialist Foot and Ankle Surgery Specialist Op. Dr. Selim Muğrabi, outpatient problems, and especially the problem of inability to walk most often due to flat insoles or high curving problems, he says. Special conditions such as stress fracture in athletes can lead to difficulty walking. In the flat insoles, which is a problem that arises from the failure of the muscle supporting the inner arch of the foot, the working disorder of this muscle may be congenital or may occur after rheumatic disease, diabetes or trauma. In the treatment, individual insoles or surgical techniques are applied to eliminate complaints. Which treatment is appropriate to the patient after a personal examination is decided.

REASONS FOR THE FORMATION OF THE FINGER
The deformity that occurs in the joint at the foot and toe junction is called "Hallux Valluks". It is stated that the main factor in this disease is the patient's compression defect. In addition, very high-heeled shoes or very sharp shoes in front of the problem triggers the emergence. In childhood, the problem is genetic. The main treatment of the disease in the thumb protrusion is performed surgically. Personalized insoles, silicone apparatuses between fingers, night splints are intended to eliminate complaints and have no therapeutic properties. Correction of foot deformity and advanced deformity together in surgical treatment is seen as the most important factor in the success of the surgical results. Patients can return to normal life approximately 3 months after this surgery.

MEANING OF PAIN IN DIFFERENT REGIONS OF THE FOOT

* It should be evaluated according to the region where the pain occurs in the foot.
* Patients around the thumbs and usually accompanied by redness hallux valgus (thumb protrusion) should be suspected of pain.
* If there is pain in the thumb and movement limitation, hallux rigidus (calcification of the thumb) should be considered in the patients.
* Mortal neurinoma (nerve compression in the foot) may occur in numb-like pain in the 3rd and 4th fingers.
* Pain in the posterior part of the foot during morning getting up from bed and passing in a few steps suggests heel spur and achilles tendinitis.
* Flat footbed should come to mind in the middle part of the foot pain caused by walking.
* Children between 8 -12 years of sport may have growth cartilage problems around heel pains.

WAIT FOR EVENING TO TAKE SHOES

Choose shoes that fit your foot structure.

* To buy shoes usually prefer evening hours. (End of the day is the most swollen of the foot. In this case, taking the shoe eliminates the possibility of the foot being stuck in the shoe.)
* When buying shoes, try the left and right singles separately and keep in mind that your toe numbers may be different.
* Always choose suitable sports shoes for walks.
* Evening dresses used in the shoes you wear your time does not exceed 2 hours.

TAKE YOUR CHILDREN TO THE PHYSICIAN BEFORE STARTING SPORT
Kiss. Dr. Selim Muğrabi says that the general health conditions should be well evaluated in children who will start sports. When foot defects are not detected correctly; It is seen that the problems such as early fatigue, lack of sporting performance, ankle sprain, knee injuries and stress fracture increase in children.

WHICH FOOT STRUCTURE FOR WHICH SPORT?
The most common problem of foot structural disorders in children is flat foot and high arch problems. When properly treated, both problems do not interfere with sports. Personalized insoles prevent the occurrence of problems. However, in untreated children in high curvature spores; can cause ankle sprain and achilles tendon problems. Flat footedness often causes problems such as inability to run fast and stress fracture. In children with severe deformity, sports preferences are decided by a doctor's examination until surgical treatment is performed. It is recommended that children with serious foot problems should be directed to swim, and children with mild foot problems should prefer sports such as basketball and volleyball as it increases the development of the muscles in the foot area.

WHAT DOES PERSONAL INSOLE HELP?
After walking and balance analysis, the person's defect in printing is detected and then a special insoles are prepared for him. These insoles help to eliminate problems such as fatigue, heel pain and knee pain caused by the structural problem of the person's foot, and also play an important role in eliminating the pain after surgery, maintaining the foot in accordance with the sport performed and maintaining balance in shortness problems.

SHORT DIFFERENCE
Your personal base; It is recommended to be used in patients with shortness differences, foot defect such as flat soles, intensive sports, standing and working for a long time and in patients who have had foot surgery.

DO NOT WEAR YOUR CHILDREN FOR UP TO 18 MONTHS
Walking reflex in children develops around 12-14 months. Kiss. Dr. Selim Muğrabi, "Children's foot and gait development in the right way to feel the right place and feet up to 18 months to walk bare feet," he says. In this period, the first step shoes should be selected in the style of booties. In addition, for children up to 4 years of age in front of the wide, soft and lace-up shoes are recommended.

DIABETIC PATIENTS SHOULD NOT DISASTER
Diabetic patients may develop loss of sensation in the soles of the feet associated with blood sugar levels. In addition, wound healing functions are weakening as these patients are more prone to infections. Therefore, injuries that may develop in the lower part of the foot are easier and heals more difficult. In addition, diabetic-related flat insoles can cause serious gait problems in patients. For all these reasons, diabetic patients need to follow up with a foot surgeon and learn to examine themselves. It is also stated that individual and diabetes-specific insoles prevent the development of these problems.


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Walking on the sand prevents flat soles!

Example: Metin Ferah

Orthopedics and Traumatology Specialist Opr.Dr. War Tunay, walking in the sand and hard slime mud prevented flat footing, he said.

Opr.Dr., the owner of a private orthopedic center in Bolu. Savaş Tunay stated that flatfoot is a disease caused by the weakness of the muscles in the foot and the muscles covering the foot,, Flatfoot is a disease usually caused by familial predisposition. In such cases, the internal muscles of the foot need to be strengthened. ”

In addition to some damage to the brain and nervous system, trauma may also occur due to trauma. Tunay said:

“If there is no proper treatment on a flat insole, the foot will be flat like the base of a bear. There is no need to do anything on flat foots with mild to moderate severity. This problem can be solved with orthopedic shoes or orthopedic insoles. Taking a pencil or a stick that has fallen to the ground with his toes, walking like a ballerina on the heel or toes, walking in sea sand or hard slime mud reinforce the muscles within the feet, making the membrane forming the dome under the foot more powerful. So the more families give their young children the opportunity to walk in the sand in the summer, the less the flat foot fears are reduced. ”


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What is a flat base? How to understand flat footbed?

Flat insoles; One of the two axes of the leg itself, the longitudinal axis of one of the longitudinal axis of the base part of the axle is in contact with the ground and the discomfort caused by the disappearance of the curve. This problem is seen in many newborn children. Flat footbed is one of the problems most parents see in their children and bring it to specialist doctors for treatment.

Is flat floor surgery necessary?
To say that a child has a flat base, you must wait at least until you are 4 years old. Because until the age of 4 an oil cushion is formed on the sole of the foot, the melting of this oil cushion and the formation of the shape of the foot occurs after 4 years. So a child up to the age of 4 should not take this too many castles on the flat base. If you have a flat foot or diagnosed child, if the child has no complaints, there is no need for much treatment if there is no pain in the feet. Orthopedic shoes and orthopedic soles are given to these patients and their flat insoles are treated. If the child or patient has pain and creates a condition that prevents him from doing sports or running, then seldom surgical treatment is sometimes performed.

Is the flat base an obstacle to military service?
Article 66 of the Turkish Armed Forces Health Capability Regulation describes the issue of flatfoot in detail. In this article, "flatfooted persons are subjected to examination and evaluation to decide whether they are suitable for military service '.

In children who have problems due to flat feet, the foot arch begins to deepen after the age of 4 and continues until 10 years of age. Stretching exercises are recommended by the experts for the foot if there is tension in the Achilles tendon in those with flat soles.

What are the benefits of using insoles?

Orthopedic insoles, which are recommended by experts specifically for the foot, also prevent foot pain and prevent the progression of the deformity. As we mentioned above, those who have flat floor problems should be exercised to resist pain hitting the achilles tendon.


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