Bilateral Cavus Feet Deformity

Overview
The term "cavus foot" is used to describe a spectrum of foot shapes that have in common a high arch. The components of cavus are increased pitch and varus of the hindfoot, plantar flexion of the midfoot, and varus and adduction of the forefoot. The cavus shape is associated with changes in the mechanics of the foot. It is less flexible and balanced than a neutral foot. Although one fifth to one quarter of the population has a cavus foot, there is little anatomic description in the literature.

Causes
Among the cases of neuromuscular pes cavus, 50% have been attributed to Charcot-Marie-Tooth disease, which is the most common type of inherited neuropathy with an incidence of 1 per 2,500 persons affected. Also known as Hereditary Motor and Sensory Neuropathy (HMSN), it is genetically heterogeneous and usually presents in the first decade of life with delayed motor milestones, distal muscle weakness, clumsiness and frequent falls. By adulthood, Charcot-Marie-Tooth disease can cause painful foot deformities such as pes cavus. Although it is a relatively common disorder affecting the foot and ankle, little is known about the distribution of muscle weakness, severity of orthopaedic deformities, or types of foot pain experienced. There are no cures or effective treatment to halt the progression of any form of Charcot-Marie-Tooth disease.

Symptoms
Many people with pes cavus have no problem at all. Sometimes it can be difficult to find shoes to fit, or the feet may ache, especially around the ankle, the outer edge of the foot or in the ball of the foot. Curled-up toes may rub on shoes.

Diagnosis
Your doctor will listen to your complaints about your cavus feet and examine you. Usually you will need a complete examination the first time you see your doctor, to see whether you have any medical condition that might cause cavus feet. Your doctor may want you to see a specialist to discuss whether you should have any more tests. This may be a neurologist (a specialist in diseases of the nervous system) or an orthopaedic foot and ankle surgeon. If tests are felt necessary, you may have blood tests, Xrays of your feet or spine, scans of your spine or head or electrical tests to see if your nerves are working. Sometimes these tests come up with a definite medical condition, but sometimes they do not.

Non Surgical Treatment
Talk with your doctor about the best plan for you. Options include the following. Supportive Devices, changes may need to be made to two simple weight provide foot support. Orthotic devices are custom-made inserts placed into shoes that provide support, stability, and cushioning. Soft-soled shoes, wider shoes, and high-topped shoes may help manage symptoms. Braces may be advised to position the foot or to treat foot drop, which can interfere with normal walking. Pads may be advised to cushion your feet to prevent corns and calluses from developing.

Surgical Treatment
The surgeon will listen to your problems, examine you carefully and analyse the exact nature of your deformity and the problems it causes. Surgery for cavus foot is often quite major, especially if the deformity is severe or very stiff.