Pes Cavus Congenital Hydrocephalus

Overview
Cavus foot is a condition in which the foot has an arch that is much higher than normal. As a result of this high arch, a large amount of weight is placed on the ball and heel of the foot when children walk or stand. Their feet become sore at the top and middle, and they have trouble finding shoes that fit properly. In addition, the high arches cause children?s ankles to roll outward slightly. This instability can lead to frequent ankle sprains.

Causes
There are many causes for a high arch foot, known as cavus. In the United States, the most common cause for a high arch foot is a form of muscular dystrophy called hereditary sensorimotor neuropathy, more commonly known as Charcot Marie Tooth disease (CMT).

Symptoms
If you are standing, the instep looks hollow and most of the weight is on the back and balls of the foot (metatarsals head).
Your high arches can be either rigid (the arch does not move to a lower height) or flexible, (the arch can move to a lower height)
If you are sitting on the edge of table with your feet hanging in the air, the front half of the foot (forefoot) will appear to be dropped below the level of the heel.
Your foot may be in a supinated position (feet will roll outwards or the heel will tilt inwards from behind)

Diagnosis
Diagnosis of cavus foot includes a review of the patient?s family history. The foot and ankle surgeon examines the foot, looking for a high arch and possible calluses, hammertoes, and claw toes. The foot is tested for muscle strength, and the patient?s walking pattern and coordination are observed. If a neurologic condition appears to be present, the entire limb may be examined. The surgeon may also study the pattern of wear on the patient's shoes. X-rays are sometimes ordered to further assess the condition. In addition, the surgeon may refer the patient to a neurologist for a complete neurologic evaluation.

Non Surgical Treatment
Treatment of high arches really depends a great deal on what?s causing them. If it?s not likely the condition will worsen with time, usually the case when the cause is NOT neurological, then more conservative treatments may be effective, enabling you to live without significant pain.

Surgical Treatment
Most people with cavus feet do not need operations. However, if your cavus feet cause a lot of pain, rub badly on your shoes so that the skin breaks down, or your foot or ankle are very unstable, and simple treatment has not helped, it may be worth considering an operation to straighten your foot. Your GP can refer you to an orthopaedic foot and ankle surgeon to advise you about surgery.