Talipes Cavus Diagnosis

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
Most cases of high arches are associated with nervous-system disorders. The conditions that can cause high arches include Cerebral palsy, Spina bifida, Muscular dystrophy, Polio, Stroke, Charcot-Marie-Tooth disease, Spinal cord tumor. The cause of high arches cannot be determined in about one in five instances. These cases are called idiopathic, meaning the condition arises from an unknown or uncertain cause.

Symptoms
A high arched foot predisposes an individual to a variety of symptoms because of the manner in which this type of foot absorbs force. The excess loading on the base of the big toe can predispose people to develop sesamoiditis and sesamoid fractures. Traction forces lead to repetitive loading of the tendons on the outside of the foot and therefore predispose patients to develop peroneal tendonitis. Compression forces are increased on the inside of the ankle, which makes damage to the inside (medial) aspect of the ankle joint more common potentially leading to talar osteochondral injuries or even ankle arthritis. The structure and loading patterns of a high arch foot also make it more susceptible to: ankle sprains; fractures on the outside of the fifth metatarsal (Jones fractures); and pain directly under the great toe (sesamoiditis).

Diagnosis
Examination of the muscle groups and muscle strength is important. Furthermore, pain along the peroneal tendons may be a sign of a peroneal tendon tear. This may result in a cavus foot much like a posterior tibial tendon dysfunction may result in flatfoot. Instability of the lateral ankle may also lead to a cavus foot position as the talus deviates into a varus position due to the laxity of the lateral ankle ligaments.

Non Surgical natural gout treatment
Podiatric Care is usually very conservative at first with a modification in shoes or making orthotics. X-rays are commonly taken to evaluate the internal bone structure of your foot. If other neuromuscular causes are suspected of causing the foot deformity your podiatrist may refer you to a specialist to test the nerves or muscles.

Surgical Treatment
Soft-tissue surgery. Cavus foot is caused in part by an over-pull of one of the lateral ankle muscles. A release of this tendon can be performed on the outside of the ankle. Additionally, a transfer of this tendon can be performed to help in correcting deformity of the ankle joint. Often patients will have a tightness of their gastrocnemius muscle, one of the main muscles in the calf. This can increase the deformity or prevent a correction from working. It is addressed with a lengthening of a part of the calf muscle or Achilles tendon. This is often performed through one or more small cuts in the back of the leg/ankle. Finally, the plantar fascia may be tight. The plantar fascia is a cord-like structure that runs from the heel to the front part of the foot. Partial or complete plantar fascia release may be done. Tendon transfers. Too much pull of certain muscles and tendons is often the cause of the deformity related with a cavus foot. Moving one of these muscles or tendons may help the foot work better. In addition, patients with a cavus foot may have weakness in moving the foot up, which is sometimes called a foot drop. In these cases, a tendon from the back of the ankle may be moved to the top of the foot to help improve strength. Bony surgery. Correcting the deformity of the foot may not be possible with soft tissue procedures alone. In these instances, one or more bone cuts (osteotomies) may be needed. Instead of a bone cut, a fusion (arthrodesis) procedure may be used. A fusion removes the joint between two bones so they grow together over time. During a fusion the bones may be held in place with plates or screws. Dorsiflexion osteotomy of the first metatarsal. This procedure flattens out the arch. Calcaneal osteotomy. This procedure is performed to bring the heel bone back under the leg. This is needed if correction of the deformity in the front of the foot does not also correct the back of the foot or ankle. A calcaneal osteotomy can be performed several ways and is often held in place with one or more screws. Fusion. Sometimes patients have a deformity that has caused damage to the joints. In these cases, soft tissue procedures or bone cuts may not be enough, and it may be necessary to eliminate the joint. Toe surgery. Clawed toes are a common problem with cavus foot deformity. This can be treated with tendon surgery, fusion or removal of part of the toe bones. Following surgery the toes are often temporarily held in place with pins.