One of the crucial components in the management of Diabetes is Foot Care but sadly it is an area that is being neglected.
The disorders of the foot are often considered to be unimportant and unworthy of thorough research and treatment, and much harm has been done by the treatment of the foot ailments by persons who have no professional knowledge of Foot Care, this frequently causing undue suffering to the patient.
The usefulness of Foot Care is not fully realized, and it is usually regarded only as a treatment of minor ailments, which does not greatly interfere with the pleasure and comforts of everyday life. Diabetes management employs Foot Care because a diabetic person’s blood circulation to the limbs is likely to become reduced, when this happens degenerative changes take place, so that person is likely to develop neuropathy (nerve damage) so your ability to feel is likely to become reduced, hence the importance of Foot Care.
General Anatomy of the Foot
To understand correctly the prevention and treatment of foot ailments, it is essential that a very thorough knowledge of the general anatomy of the foot is understood, not only of the number of bones, but also of the chief structure forming the framework of the foot and the various nerves, arteries, muscles and tendons with their relative functions and general maintenance.
Firstly, there are 26 bones in the framework of the foot, these are divided into three (3) sections, the tarsus section, the metatarsus section and the phalanges.
The Tarsus section consist of the oscalcis or heel bone (the largest bone in the foot) and the astragalus which forms the ankle joint by articulation with the tibia bone of the leg. THe scaphoid at the top side of the higher instep or the transverse arch of the foot, the three cuneiform bones, the outer or external, the inner or internal and the centre cuneiform bone, the cuboid bone, which lies to the outside of the foot in front of the heel bone or oscalcis.
The Metatarsal section consist of the five metarsal bones forming the arches of the foot. THese are numbered 1 to 5, No.1 metatarsal bone being the bone leading to the big toe on the inside of the foot. These bones have heads, which are called the metatarsal heads, and these connect the five metatarsal bones with the corresponding bones of the toes.
The Phalanges of the toes – there are fourteen bones of the phalanges section, three to each toe, with the exception of the big toe, which has only two bones.
The bones of the foot are very irregularly shaped, the largest bone of the foot being the heel bone or the oscalcis, the smallest bone is the distal phalanx of the 5th toe. The structure of the foot is very complicated, the bones being held in position by ligaments and muscular coverage, and when they are strong and healthy, they support the four arches of the foot.
DISEASES OF THE FOOT
The toenails are liable to many disorders from accidents and their peculiar structure renders them capable of being curved or bent under the influence of heat, moisture or pressure from the shoes or boots may force the toenails into various shapes thereby causing injury and discomfort.
The toenails are somewhat thicker than those of fingers and therefore, more adapted to protect the toes from many serious injuries. Some nails, generally through accidental causes, begin to thicken and acquire after a time such a degree of thickness and deformity as to render them exceedingly difficult in cutting and are consequently allowed to grow to such an extent that they snake themselves around the toe thereby causing pain.
When in this state can only be cut with a strong pair of nail nippers. When the nail is of pyramidal shape, great care should be taken not to injury or cut the tuft of enlarged papillae which is frequently found under it. The cutting or reconstruction must be performed only by a Chiropodist/Podiatrist who will understand how to cut and treat whatever may be found under the nail. This condition is known as Ram’s Horn Nail (Onychogryphosis).
DISEASES OF THE FOOT: