Arches of

foot

FUNCTIONS OF FOOT

Support body weight

Serves as a lever to propel
the body forward in walking
& running

FUNCTIONS OF FOOT
IF THE FOOT
POSSESSED A

SINGLE BONE

It cannot adapt
itself to uneven
surfaces
Its propulsive
action depends
entirely on
gastrocnemius &
plantaris

BUT

Gastrocnemius & plantaris

FUNCTIONS OF FOOT
SINCE THE FOOT IS
FORMED OF

SMALL BONES &

MANY JOINTS

It can adapt itself

to uneven
surfaces
Long flexors &
small muscles of
foot assist in
propulsive action

Plantar
arches ?

Functions and mechanics of arches

1. Proportional distribution of body
weight.
60 lbs

30 lbs

30 lbs
6

2. Segmented lever
action

3.Protective action

4. Shift of weight
distribution

Invertors and evertors

5. Dynamic and pliable

Foot in weight bearing
Somewhat flattening of arches

estoration of original contour in non weight bearing

Spring board effect

Medial and
lateral

Anterior and posterior

10

Medial longitudinal arch

Medial arch : lateral
arch
9:4

11

Summit

Pillar
s

12

Key stone
Sustentaculum
tali
Navicul
ar
socket

Resilien
Spring ligament
t

13

Lateral longitudinal arch

Summit

Pillars
14

Key
stone
Rigi
d
Short plantar
ligament
Long plantar

15

TRANSVERSE ARCHES
Approximation of
both feet

16

Maintaining factors

?
17

Slings

Shape of the bones

Intersegmental tiers
Tie beams
Shape of the bones
Tie beams

Intersegmental tiers

Slings
18

MECHANISM OF ARCH SUPPORT

SHAPE OF
BONES

Bones are wedgeshaped with the

thin edge lying
inferiorly
This applies
particularly to the
bone occupying
the center of the
arch keystone

Maintenance of medial
longitudinal arch

Shape of the
bones
Sup
.

Inf.

Thinner edge

20

MECHANISM OF ARCH SUPPORT

INFERIOR
EDGES OF
BONES ARE
TIED
TOGETHER

ntersegmental tiers...
Tibialis posterior
tendon

Spring ligament

22

MECHANISM OF ARCH SUPPORT

INFERIOR
EDGES OF
BONES ARE
TIED
TOGETHER

Tie-beams
Flexor digitorum
brevis (1)

Plantar aponeurosis
Abductor hallucis (1)
Flexor hallucis brevis (3)
Flexor hallucis longus (2)
24

Slings
Superficial fibers' of deltoid liga
Tibialis posterior
Tibialis anterior

25

Maintenance of lateral arch

Shape of bones

Intersegmental tiers

Long plantar ligament

Short plantar ligament
Plantar aponeurosis
26

Tie beams

ADM
FDB
FDL
FDM
B

27

Slings

28
Peroneus longus Peroneus brevis Peroneus tertius

Maintenance of transverse
arch
Shape of bones

29

Intersegmental tiers

Deep transverse

30

Intersegmental tiers

Ant.
Lat.

med.
Post.

Dorsal interossei
Transverse head of Ad.H
31

Tie beams

32

Peroneus
Tibialis
anterior
tertius

33

Anomalies
A. Flat foot

Causes:
Congenital vertical talus
Obesity
Postural
Secondary to anatomical defect
elsewhereExternal limb rotation
Genu valgum
Equinus deformity of
Othersankle
Paralytic
Spasmodic
Traumatic

34

Feiss line assessment

Normal foot

Flat foot

35

Pes cavus
Plantar flexion
at
transverse
tarsal joint.
Dorsi-flexion at
MTP joint.

Plantar flexion at
interphalangeal
joint

Causes:
Idiopathic

Mostly
36

Feiss line assessment

Na
v
ic u
l
ar

37

Club foot
Primarily of 4
Talipes equinus
types

Talipes
Talipes
calcaneus

equinovarus

Talipes varus

Talipes valgus

38

Etiology
A. Idiopathic club
foot Mechanical theory
Ischemic theory
B. Secondary club
foot
Paralytic disorder

Clinical
features

Smaller size of foot

Foot in equinus, varus and adduction
Smaller heel
Deep skin creases
Lateral bony prominence
39

Treatment
Manipulation and castingCorrection of adduction
deformity is done first
followed by inversion
and than equinus
deformity
Z-plasty of tendoachilles
Tendon transfer- tibialis anterior
tendon transfer to the outer side of
foot.
Triple arhrodesis- Suitable wedge
taken off
Subtalar, calcaneo-cuboid and talonavicular joints are fused.
40

Hallux valgus

BUNION

Great toe is deviated laterally at MTP

Cause:

Hereditary, high heels, narrow

pointed shoes
Pathology:
medial deviation of first
metatarsal, bunion
41

Hammer toe
Full flexion deformity at

proximal interphalangeal
joint
CauseImbalance
TreatmentArthrodised in straight
position.

42