Compare Pes Planus And Pes Cavus

Overview
Cavus foot is a condition where the arches in the foot are significantly higher than a normal arch. This causes the heel to point inward and the toes to flex. Children with this condition typically develop it slowly from the time they begin to walk until 10 years old. Most often this condition occurs in conjunction with another musculoskeletal or nervous system disorder.

Causes
Pes Cavus is typically a result of a fixed plantar flexion of the foot. Plantar Flexion is the movement of the ankle, pointing the toes away from the shin (think pressing a gas pedal in your car). However, a fixed plantar flexion does not guarantee that starting a running program person has pes cavus.

Symptoms
The arch of a cavus foot will appear high even when standing. In addition, one or more of the following symptoms may be present. Hammertoes (bent toes) or claw toes (toes clenched like a fist). Calluses on the ball, side, or heel of the foot. Pain when standing or walking. An unstable foot due to the heel tilting inward, which can lead to ankle sprains. Some people with cavus foot may also experience foot drop, a weakness of the muscles in the foot and ankle that results in dragging the foot when taking a step. Foot drop is usually a sign of an underlying neurologic condition.

Diagnosis
Examination of the muscle groups and muscle strength is important. Furthermore, pain along the peroneal tendons may be a sign of a peroneal tendon tear. This may result in a cavus foot much like a posterior tibial tendon dysfunction may result in flatfoot. Instability of the lateral ankle may also lead to a cavus foot position as the talus deviates into a varus position due to the laxity of the lateral ankle ligaments.

Non Surgical Treatment
Any fixed deformity must be accommodated, for example by cupping and supporting the varus heel and providing a small heel raise to compensate for forefoot plantaris. It has been shown that an orthosis that allows the first metatarsal to drop can decrease calcaneal dorsiflexion, and that this coincides with a reduction in foot pain.

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.