The term pes cavus encompasses a broad spectrum of foot deformities. Three main types of pes cavus are regularly described.
The most common type of pes cavus, is seen primarily in neuromuscular disorders such as Charcot-Marie-Tooth disease, and in cases of unknown aetiology, conventionally termed as ?idiopathic?. Pes cavovarus presents with the calcaneus in varus, the first metatarsal plantarflexed and a claw-toe deformity. Radiological analysis of pes cavus in Charcot-Marie-Tooth disease shows the forefoot is typically plantarflexed in relation to the rearfoot.
Seen primarily following paralysis of the triceps surae due to poliomyelitis, the calcaneus is dorsiflexed and the forefoot is plantarflexed. Radiological analysis of pes calcaneocavus reveals a large talo-calcaneal angle.
The calcaneus is neither dorsiflexed nor in varus, and is highly arched due to a plantarflexed position of the forefoot on the rearfoot. A combination of any or all of these elements can also be seen in a ?combined? type of pes cavus that may be further categorized as flexible or rigid. Despite various presentations and descriptions of pes cavus, all are characterised by an abnormally high medial longitudinal arch, gait disturbances and resultant foot pain due to diabetes; http://kendalgelfand.weebly.com, pathology.
Cavus foot commonly occurs as a result of an underlying medical or neurological condition, such as polio, muscular dystrophy or cerebral palsy. Cavus foot may also occur as a result of congenital defects. They may be inherited from a parent, or they may result from an orthopedic condition or a disease of the nerves or muscles.
Symptoms vary depending on whether your high arches are inherited or stem from a neurological condition. With high arches, your heel (or heels if both feet are affected) will likely be tilted medially (toward the body?s midline) at the ankle. When weight is put on the foot, the arch does not flatten at all. Other symptoms include pain when standing, walking or running due to the extra stress on the metatarsals (bones at the top of the foot). Corns and calluses on the ball or side of the foot, or the heel. Arch inflexibility and stiffness. Ankle sprain due to instability of the foot. Very tight calf muscles at the lower leg.Pain when standing, walking or running due to the extra stress on the metatarsals (bones at the top of the foot)
Corns and calluses on the ball or side of the foot, or the heel
Arch inflexibility and stiffness
Ankle sprain due to instability of the foot
Very tight calf musclesat the lower legPain
Very tight calf muscles
Diagnosis of cavus foot initially includes a review of the patient?s family, past medical and surgical history. Your Weil foot and ankle physician will then examine your feet and lower extremities, looking for a high arch and possible calluses, hammertoes, claw toes, and any other structural abnormalities. The foot and ankle are placed through specified movements, testing for muscle strength and deep tendon reflexes, as well as observing the patient?s walking pattern and coordination movements. The entire limb may be examined if a neurological condition is expected. The surgeon may also study the pattern of wear on the patient?s shoes. X-rays are typically ordered to further assess the condition and underlying bony anatomy and structure. Your Weil foot and ankle physician may possible refer the patient for further testing and/or to a neurologist for further work-up.
Non Surgical Treatment
Depending on the severity and presence of debilitation, non-surgical and surgical treatment options are extensively reviewed by your Weil foot and ankle physician. Non-surgical treatment options we provide include, but are not limited to: shoe gear modifications, bracing and/or strappings, custom-molded arch supports; all of which assist in positioning the foot properly and provide improved shock absorption.
Possible operations include straightening your toes to stop them rubbing on your shoes and to take the pressure off the ball of your foot, breaking and re-shaping one or more bones in the front, middle or heel of your foot to straighten the deformity, re-shaping and stiffening one or more joints, usually in the middle or heel of your foot, to straighten the deformity and make your foot more stable, moving one or more of the tendons of your foot to another part of the foot to give more strength to a weak area, tightening the ligament of your ankle or strengthening it with another bit of tissue to stop your ankle going over. You might need more than one option from this list, and it may not be possible to do it all at once. Your surgeon will discuss the options fully with you, including the chances of success and failure, to help you make up your mind about what you want to do.
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