Difference Between Pes Cavus And Pes Planus

Overview
Children with cavus foot have arches that are much higher than usual. Often, their heels point inward, and all of their toes are flexed. Children with cavus foot have trouble finding wide-heeled shoes assist that fit. The tops and middles of their feet become sore. They may have pain, and develop thick calluses under the ball and at the outer edges of their feet. Because their high arches make their ankles roll outward slightly, children with cavus foot may feel like their ankles are about to give out. Sometimes they sprain their ankles over and over again.

Causes
Pes cavus may be hereditary or acquired, and the underlying cause may be neurological, orthopedic or neuromuscular. Pes cavus is sometimes, but not always connected through Hereditary Motor and Sensory Neuropathy Type 1 (Charcot-Marie-Tooth disease) and Friedreich's Ataxia; many other cases of pes cavus are natural.

Symptoms
The foot serves as an organ of load distribution, shock absorption, balance and propulsion. Pes cavus interferes with all of these functions. Supination of the hindfoot normally results in a change of the foot from a loosely packed, flexible, energy absorbing structure to a tightly packed, stiffer lever. This change occurs naturally during the gait cycle. When the hindfoot remains supinated throughout the gait cycle, however, the reduced flexibility lessens the foot?s capability as a shock absorber and diminishes its ability to balance on uneven ground. Hindfoot varus also leads to an increased moment on the ankle, making ankle inversion injuries common. Eventually there may be dramatic varus tilting of the ankle and secondary osteoarthritis.

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
Non-surgical treatment is instituted early and is chiefly delivered by podiatrists and orthotists, preferably working alongside doctors in a foot and ankle clinic. Orthotic treatment can broadly be separated into four types, pressure relief, correction of deformity, accommodation of deformity, and splinting. Chiropodists and podiatrists can provide simple devices, but more involved orthoses are made by an orthotist. A simple cushioning orthosis alone may help symptoms from pressure overload. Pressure on the metatarsal heads is alleviated by a total contact orthosis that widens the contact area. One randomised controlled trial has compared custom-molded, semi-rigid orthoses with soft, sham inserts. The custom inserts caused a clinically and statistically significant reduction in foot pain scores and peak plantar pressure at three months, and a significant increase in quality of life measures.

Surgical Treatment
In severe cases of cavus, surgical intervention is often necessary. The main consideration for surgical planning is the cause of the cavus deformity. Consider whether it is a structural deformity or one caused by an underlying traumatic event such as a peroneal tendon tear or ankle instability. Furthermore, in either a structural or traumatic case, it is important to consider if the cavus is from a plantarflexed first ray only, a calcaneal varus only or a combination of the two deformities together. After considering all the information, one can plan for surgery.