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3 Place Maurice-Charretier
Charleville-Mezieres, CHAMPAGNE-ARDENNE 8000
If you have feet with a high arch or instep while standing, you have a foot condition known as pes cavus. The arch, or instep, runs from the toes to the heel on the bottom of your foot. Pes cavus is the opposite of flatfeet (pes planus). Pes cavus is less common than pes planus. Pes cavus usually occurs in both feet and at an early age. The sudden appearance of the pes cavus, or if it appears in one foot only, may be the result of trauma or a neuromuscular disease.
An inherited disorder called Charcot-Marie-Tooth disease (CMT) is the most common cause of cavus foot. But there is a long list of disorders that may cause the problem. Children who have muscular dystrophy (MD) Cavus foot
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affect only one foot, too. Cavus foot in one foot is more common in children with injuries to the nerves in their legs or spinal cord or to the muscles in their legs. Other conditions that make it more likely a child will develop cavus foot are poliomyelitis, cerebral palsy and spinal cord tumor.
Cavus foot is often caused by a neurologic disorder or other medical condition, such as cerebral palsy, Charcot-Marie-Tooth disease, or stroke. A high-arched foot may cause one or more of the following symptoms. Discomfort when walking barefoot on hard surfaces. Hammertoes (bent toes). Claw toes (toes clenched like a fist). Frequent ankle
. Haglund?s Deformity (bony enlargement of the back of the heel bone). Calluses on the ball, side, or heel of the foot.
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
The management depends on the radiological characteristics. Any motor impairments due to a neurological disease must be corrected before the induced osteoarticular deformities are treated. To avoid having to perform triple arthrodesis at growth completion, preference should be given to surgery during growth to correct the muscle imbalances.
Surgery to correct cavus foot may be necessary in situations where the symptoms are likely to get worse over time or when pain and instability cannot be corrected with external orthopedic devices. The main goals of surgery are:
all the existing deformity of the toes, the high arch, the ankle and the muscle imbalance.
as much motion as possible.
the deforming muscle forces around the foot and ankle.
stability to the ankle.
ankle arthritis from occurring as a result of the chronic deformity of the foot and the instability of the ankle.
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