Cavovarus Talipes Cavus Symptoms

Overview
Pes cavus is a deformity of the foot which has a very high arch and is relatively stiff. This deformity does not flatten on weight-bearing. A high arch with a medially angulated heel is called pes cavovarus. When this is complicated by foot drop and equinus of the ankle, this is called pes equinocavovarus. In cases where the primary deformity is excessive ankle and hindfoot dorsiflexion, it is called pes calcaneovarus.

Causes
Most cases of high arches are associated with nervous-system disorders. The conditions that can cause high arches include Cerebral palsy, Spina bifida, Muscular dystrophy, Polio, Stroke, Charcot-Marie-Tooth disease, Spinal cord tumor. The cause of high arches cannot be determined in about one in five instances. These cases are called idiopathic, meaning the condition arises from an unknown or uncertain cause.

Symptoms
As with certain cases of flat feet, high arches may be painful due to metatarsal compression; however, high arches, particularly if they are flexible or properly cared-for-may be an asymptomatic condition. People with pes cavus sometimes though not always, have difficulty finding shoes that fit and may require support in their shoes. Children with high arches who have difficulty walking may wear specially designed insoles, which are available in various sizes and can be made to order.

Diagnosis
Diagnostic testing often includes magnetic resonance imaging (MRI) if one suspects a peroneal tendon problem or ankle instability. Perform electromyography and nerve conduction velocity testing if you suspect Charcot Marie Tooth. If a high suspicion of muscular dystrophy is present, perform a sural nerve biopsy.

Non Surgical treatment for hammer toe deformity
If a considerable part of the deformity is flexible, a corrective orthosis should be used. For example, in forefoot-driven cavovarus, the hindfoot is flexible, and so an orthotic shoe insert incorporating lateral forefoot posting (support) and recessing under the first metatarsal will allow the hindfoot to correct. For ankle instability, the lateral side of the hindfoot post can be built up as well as the lateral forefoot post, creating a pronatory moment on the forefoot that counteracts the excessive supinatory moment in the hindfoot.

Surgical Treatment
Surgery to correct cavus foot may be necessary in situations where the symptoms are likely to get worse over time or when pain and instability cannot be corrected with external orthopedic devices. The main goals of surgery are correcting all the existing deformity of the toes, the high arch, the ankle and the muscle imbalance. Preserving as much motion as possible. Rebalancing the deforming muscle forces around the foot and ankle. Adding stability to the ankle. Preventing ankle arthritis from occurring as a result of the chronic deformity of the foot and the instability of the ankle.