Cavus Foot Surgery Pre And Post

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 shoes 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 skimpy swimwear high heels japanese 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
Cavus foot commonly occurs as a result of an underlying medical or neurological condition, such as polio, muscular dystrophy or cerebral palsy. Cavus foot may also occur as a result of congenital defects. They may be inherited from a parent, or they may result from an orthopedic condition or a disease of the nerves or muscles.

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
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
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 patients with inflexibility, arthrodesis sacrifices little, and relieves joint pain. The foot can be re-orientated by excising wedge shaped portions of the joints. The triple arthrodesis of subtalar, talonavicular and calcaneocuboid joints is very commonly used. Midfoot arthrodeses may be more appropriate, depending on the maximum site of pain and deformity.