Cavus Foot Flashcards
Which disorder can present in the young patient with symptoms such as abnormal gait, forefoot pain and ankle instability?
Charcot-Marie-Tooth
Why is a neurologic evaluation mandatory in cavus foot patients?
Because it is often assiceted with different neurological issues leading to the imbalance of intrinsic and extrinsic muscles.
What genetic properties are carried in charcot marie tooth disease type 1?
It is an autosomal dominant disorder.
What happens when the lumbricles are absent and the long flexors act?
The lumbricles are no longer able to tighten the wing and thus, there is extension of the metatarsophalangeal joints and hyperflexion of interphalangeal joints.
(normal is flexion of mpj extension of ipj).
What are the two saggital plane deformities in cavus foot?
Posterior cavus foot with a vertical calcaneus (in varus).
Anterior cavus foot due to weak intrinsic muscles.
What does the coleman bock test check?
Checks the flexibility of the hindfoot varus when the forefoot is rigixd.
If the rearfoot moves following the block the STJ is mobile thus forefoot surgery incdicated.
If the calcaneus does not correct, it is a hindfot problem.
What is Hibb’s angle?
Angle between longitudinal axis of the calcaneus and forefoot.
Normally is 130 degrees.
the apex of this angle is close to the chopart joint.
Which measurement can be used to determine the apex of cavus deformity?
Meary’s line
What is a steindler plantar release?
Used for mild and flexible cavus feet.
Internal flexors and plantar fascia of the foot are cut away from the calcaneus.
What is the jones procedure for cavus foot?
Transfer of EHL to the neck of the first metatarsal. This elevates the first ray and is usually accompanies by interphalangeal joint fusion.
Dwyer calcaneal osteotomy
Lateral wedge resection of the calcaneus to introduce more pronatory forces in a cavus/supinated foot.
When comparing arthrodesis to tarsectoies which is bettr in correcting rigid cavus foot?
Tarsectomies are preferred to achieve a plantigrade foot.
How will a patient’s gait appear in a patient with cavus deformity?
The patient will show a deformed foot suring swing phase.
Heel strike does not occur due to the equinus forefoot hitting firrst.
Shoes will wear in the anterior part of the sole and the dorsal aspect is deformed.
Which angle can be used in the cavus foot to deterine the apex of the cavus deformity?
Meary’s angle.
Look for where Meary’s angle is broken.
