Pes cavus (in medical terminology, also high back foot , high arch , talipes cavus , cavoid , and type consecrated leg ) is a type of human foot where the sole of the foot is clearly hollow while holding the load. That is, there is fixed plantar flexion in the legs. The high arch is the opposite of flat feet and somewhat less common.
Video Pes cavus
Presentations
Pain and disability
As in flat foot cases, high curvature may be painful because of metatarsal compression; However, arches - especially if they are flexible or properly maintained - may be asymptomatic.
People with pes cavus sometimes - though not always - have trouble finding the right shoes and may need support in their shoes. Children with high arches who have difficulty walking can wear specially designed soles, which are available in various sizes and can be made to order.
Individuals with pes cavus often report foot pain, which can lead to significant functional limitations. The range of complaints reported in the literature include metatarsalgia, pain under the first metatarsal, plantar fasciitis, painful callosities, ankle arthritis, and Achilles tendonitis.
There are many other symptoms that are believed to be associated with cavus legs. These include shoe fixing problems, lateral ankle instability, lower extremity stress fractures, knee pain, iliotibial band friction syndrome, back pain and tripping.
Foot pain in people with pes cavus can occur due to abnormal loading of abnormal plantar pressures because, structurally, cavoid feet are considered rigid and non-shock absorbers and have reduced soil contact areas. Previously there was a report about the relationship between excessive plantar pressure and foot pathology in people with pes cavus.
Maps Pes cavus
Cause
Pes cavus may be hereditary or acquired, and the underlying cause may be neurological, orthopedic, or neuromuscular. Pes cavus is sometimes - but not always - connected via Hereditary Motor and Sensory Neuropathy Type 1 (Charcot-Marie-Tooth disease) and Friedreich's Ataxia; many other cases of natural pes cavus.
The cause and mechanism of deformation underlying pes cavus is complex and not well understood. Factors considered to be influential in pes cavus development include muscle weakness and imbalance in neuromuscular disease, congenital clubfoot residue effects, post-traumatic bone malformation, contractar plantar fascia, and Achilles tendon shortening.
Among the cases of neuromuscular pes cavus, 50% have been associated with Charcot-Marie-Tooth disease, CMT, which is the most common type of neuropathy inherited with an incidence of 1 per 2,500 affected people. Also known as Hereditary Motor and Sensory Neuropathy (HMSN), is genetically heterogeneous and sometimes idiopathic. (See CMT Association website) There are many types and subtypes of CMT, and as a result, can be present from infancy to adulthood. CMT is a peripheral neuropathy, which affects the first distal muscle as weakness, clumsiness, and often falls. Usually the effects of the first leg, but sometimes can be started at hand. Charcot-Marie-Tooth disease can cause painful foot-shaped abnormalities such as pes cavus. Although it is a relatively common disease, many doctors and lay people are not familiar with it. There is no effective cure or treatment to stop the development of all forms of Charcot-Marie-Tooth disease today.
The development of cavus leg structure seen in Charcot-Marie-Tooth disease has previously been associated with an imbalance of muscle strength around the feet and ankles. A hypothetical model proposed by various authors describes the relationship in which weak evertor muscles are dominated by stronger invertor muscles, causing the forefoot to be added and the rearfoot reversed. Similarly, weaker dorsiflexors are controlled by a stronger plantarflexor, causing the first metatarsal and anterior pescavus plantopllex.
Pes cavus is also evident in people without neuropathy or other neurological deficits. In the absence of neurological, congenital, or traumatic causes of pes cavus, the remaining cases are classified as 'idiopathic' because their etiology is unknown.
Diagnosis
In radiographic projection of body weight, pes cavus can be diagnosed and assessed by some features, most importantly the subluxation of medial peritalar, increased calcane paricale (variable) and abnormal talar-1 metatarsal angle (Meary angle). Medial medial subluxation can be represented by medial angle of talonavicular coverage.
Type
The term pes cavus covers a wide spectrum of foot deformities. The three main types of pes cavus are regularly described in the literature: pes cavovarus, pes calcaneocavus, and 'pure' pes cavus. The three types of pes cavus can be distinguished by their etiology, clinical signs and radiological appearance.
Pes cavovarus , the most common type of pes cavus, is seen primarily in neuromuscular disorders such as Charcot-Marie-Tooth disease and, in the unknown case of etiology, is conventionally called 'idiopathic'. Pes cavovarus comes with a calcaneus in varus, the first plantarflexed metatarsal, and claw-toe deformity. Radiologic analysis of pes cavus in Charcot-Marie-Tooth disease shows that forefoot is usually plantarflexed in relation to rearfoot.
At the foot of the calcaneocavus calc, most noticeably follows the paralysis of suric triceps due to poliomyelitis, the calcaneus is dorsiflexion and the forefoot is plantarflexed. Radiological analysis of calcaneocavus pescus shows a large talo-calcaneal angle.
In 'pure' pes cavus , the calcaneus is not dorsofleksi or varus and is highly curved due to the plantarflexed position of the forefoot on the rearfoot.
The combination of any or all of these elements can also be seen in 'pes cavus' combined types which can be further categorized as flexible or rigid.
Despite various presentations and descriptions of pes cavus, not all incarnations are characterized by abnormally high medial elongated arch, gait disturbance, and foot pathology produced.
Treatment
Surgical treatment only begins when there is severe pain, because the available surgery can be difficult. Otherwise, high curves can be handled with care and proper care.
It is recommended that conservative management of patients with painful pes cavus usually involves strategies to reduce and distribute plantar loads of pressure with the use of foot orthoses and special pads of pads. Other non-surgical rehabilitation approaches include stretching and weakened muscle strengthening, plantar callosystem debridement, osseous mobilization, massage, chiropractic manipulation of feet and ankles, and strategies to improve balance. There are also many surgical approaches described in the literature that aim to correct deformities and rebalance the legs. Surgical procedures are divided into three main groups:
- soft-tissue procedures (eg plantar fascia release, elongation of the Achilles tendon, tendon transfer);
- osteotomy (eg metatarsal, midfoot or calcaneal);
- bone stabilizer procedure (eg triple arthrodesis).
Epidemiology
There are some good prevalence estimates for pes cavus in the general population. While pes cavus has been reported between 2 and 29% of the adult population, there are some limitations of prevalence data reported in this study. Population-based studies show a prevalence of cavus foot about 10% .
History
The term pescavus is Latin for "hollow feet" and is identical to the terms talipes cavus, cavoid feet, high arched legs, and supination foot types. Pes cavus is a multiplanar deformity characterized by an abnormal medial elongated arch. Pes cavus generally has a hindfoot (inverted) varus, a plantothlex position of the first metatarsal, an additional toe, and a contracture of the lower part of the toe. Despite many anecdotal reports and hypothetical descriptions, very little rigorous scientific data exists on the assessment or treatment of pes cavus.
See also
- Arch of the foot
- Foot type
- En pointe
- Bind feet
- Rocker underfoot
References
External links
- International Foot and Ankle Biomechanics Community (i-FAB)
Source of the article : Wikipedia
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