The cavus foot
The cavus foot
The cavus foot is a deformity characterized by an exaggerated increase in the plantar vault (which is an arch formed by the bony, ligamentous and muscular elements of the foot; its function is to cushion the impact that occurs during walking, in addition to allowing adaptation to the irregularities of the terrain), along with heel deviations (either in the varus, ie towards the midline, or in valgus, out of the midline) and claw-shaped toes.
Also called cavus foot is one that has a medial longitudinal arch height greater than normal. This definition alone does not imply a syndrome. Many causes can lead to this deformity. Usually cavus foot also has other concomitant deformities, usually depending on the cause.
Causes of pes cavus
There are different causes of pes cavus. Among them we can find:
- Neurological cavus foot
It results from muscle imbalances. These imbalances occur between the intrinsic and extrinsic muscles of the foot: shortening of the extensor muscles of the toes and intrinsic of the foot and distension of the calf muscles (specifically triceps sural). One structure that is also important to mention is the plantar aponeurosis which, despite not having muscle fibers, shortens and contributes to the deformation of the foot.
- Essential cavus foot
They are the feet in which there is an increase in the plantar vault, because there is no pathology to which this increase is attributed. Soccer players, basketball players, and even dancers are the most likely to suffer from this deformity.
- Secondary foot cavus
It results after establishing osteoarticular alterations (such as congenital, traumatic or major joint destruction as in rheumatoid arthritis) or retractions of the soft tissues in the support of the foot (such as scars, burns or ischemic processes).
Treatment
It is to be expected with age the development of a certain cavus foot in normal people, especially women. These feet are within normal limits radiologically, however they are usually painful in the metatarsal. Metatarsalgia will be combated with insoles that discharge the anterior part of the foot. If calluses already exist, the insoles will have a special design according to the position of the hyperpressure zones. In the cavus foot of an adolescent, idiopathic, there is a progression of the deformity that cannot be treated with conservative means such as insoles. The treatment is usually surgical: tendon transposition; osteotomy of the calcaneus; to correct the varus; osteotomies of the midfoot, etc. Neuropathic cavus feet are usually treated surgically. But after the operation, they will often have to use anterior discharge insoles. In many cases, the footwear must be modified to allow the back of the foot (instep) to be accommodated.
Dr. Leopoldo Maizo - Orthopedic Surgeon
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