Does Pes Cavus Feet Have To Have Surgical Procedures

Overview
When a person with a cavus foot stands, the middle of the foot seems to be raised higher off the ground than normal. The heel may be drawn in towards the inner side, and the toes may also be drawn inwards. Some people with cavus feet also have curled-up "claw" toes. Although the most obvious thing about a cavus foot is usually the high arch, this appearance is actually produced by other more basic deformities in the foot. In all cavus feet the front part of the foot is drawn downwards more than normal, and the part on the side of the big toe (first ray) is usually drawn down most of all. The result is to tip the arch upwards, and also to tip the foot onto its outer side. It is this combination that produces the appearance of a high arch and a large space under the foot.

Causes
High arches are not nearly as common as low calorie diet arches. They can be caused by a few different things. In some cases, this condition can be a symptom of a neurological disease, such as polio, Charcot-Marie-Tooth disease, cerebral palsy, muscular dystrophy, or even a stroke. These neurological conditions can affect your muscle tone, causing some muscles in your foot to be weakened or even paralyzed, while others remain just as strong as always.

Symptoms
Pain and stiffness of the medial arch or anywhere along the mid-portion of the foot. There may be associated discomfort within and near the ankle joint. The knees, hips, and lower back may be the primary source of discomfort. Pain in the ball of the foot, with or without calluses. Heel pain.

Diagnosis
Diagnosis of cavus foot includes a review of the child?s family history. A foot exam to look for a high arch, calluses, hammertoes and claw toes. A test of muscle strength in the foot, toes, ankle and leg. Observing the child?s walking pattern and coordination. X-rays. Other testing may include electromyogram and nerve conduction velocity (EMG/NCV) studies, blood test for CMT and magnetic resonance imaging (MRI) study of the spine and brain.

Non Surgical Treatment
Foot orthotic devices can provide support for stressed joints and soft tissues. They are often constructed to increase shock absorption. The redistribution of weight relieves stress on the metatarsals. Generally, custom-made semi-rigid or semi-flexible functional posted orthotics are most effective for this foot type. They often include shock absorbing material in the arch. These devices are prescribed based on a thorough biomechanical examination by a qualified podiatrist. Orthotic therapy is very effective for patients with this foot type. Over-the-counter arch supports may be helpful for mild cases, but they are often a poor fit for persons with this condition.

Surgical Treatment
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.