Cavus Foot Deformity Correction

Overview
Although medical knowledge regarding pes cavus exists, the research and treatment options, as well as any theories or hypotheses as to why humans develop this deformity, are quite limited. Traditionally, we have considered pes cavus a neuro?muscular problem with a surgical answer. By combining what is known with what we can hypothesize, perhaps we can establish a new and more successful approach to pes cavus.

Causes
The cause and deforming mechanism underlying pes cavus is complex and not well understood. Factors considered influential in the development of pes cavus include muscle weakness and imbalance in neuromuscular disease, residual effects of congenital clubfoot, post-traumatic bone malformation, contracture of the plantar fascia and shortening of the Achilles tendon.

Symptoms
The symptoms of a high arch foot will vary depending on the severity of the arch height, the availability of joint motion in the foot to help lower the arch and the activity levels or occupational demands placed on the high arched feet. Most people with high arches will have no pain or any other symptoms. Symptoms may vary from a mild problem with shoe fitting to significant disability.

Diagnosis
Diagnostic testing often includes magnetic resonance imaging (MRI) if one suspects a peroneal tendon problem or ankle instability. Perform electromyography and nerve conduction velocity testing if you suspect Charcot Marie Tooth. If a high suspicion of muscular dystrophy is present, perform a sural nerve biopsy.

Non Surgical Treatment
If your high arches are inherited, you likely can treat mild cases with insoles, orthotics, differently fitting shoes or corrective shoes - available over the counter or through a podiatrist. If you have frequent or chronic pain when walking or standing, consult a podiatrist or orthopedist. If you unexpectedly develop a high arch in one or both feet, it could signify a developing neurological condition. Many procedures can relieve foot pain. Quick medical response can limit the likelihood of long-term disability.

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.