Pes Cavus Surgery Problems

Overview
The arch of the foot is a pretty important piece of your anatomy. Unfortunately, arches really work best when they?re at a nice middling height, too low, and you?ve got flat feet, too high, and you?ve got cavus foot, or a high-arched foot. High arches might show up in both feet at once, or sometimes only in one foot.

Causes
High arches are not nearly as common as low 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
If you are standing, the carp think 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
General examination may reveal features of neurological conditions such as ?champagne bottle legs? (Charcot-Marie-Tooth disease), scoliosis in Friedreich ataxia, or a naevus, dimple or patch of hair over the spine in spina bifida occulta. The neurological examination should include a search for signs of peripheral nervous disease, such as muscle wasting, weakness and sensory deficit, and signs of central nervous disease, such as pyramidal signs, cerebellar signs or cranial nerve abnormalities. Accurate serial recording of power in individual muscle groups will allow the clinician to follow the disease over time and detect neurological progression.

Non Surgical Treatment
Suggested conservative management of patients with painful pes cavus typically involves strategies to reduce and redistribute plantar pressure loading with the use of foot orthoses and specialised cushioned footwear. Other non-surgical rehabilitation approaches include stretching and strengthening of tight and weak muscles, debridement of plantar callosities, osseous mobilization, massage, chiropractic manipulation of the foot and ankle and strategies to improve balance.

Surgical Treatment
If the above techniques do not help relieve pain and provide stability, two surgeries within the span of two weeks may be needed. During the first surgery, the orthopedic surgeon releases the tightest of the soft tissues in the arch, which causes the rest of the tissues to relax. During the second operation, the surgeon uses a bone graft to reshape at least one bone and moves several tendons to improve muscle balance.