Pes cavus

Question 0

What is its pathology?

Answer 0

A contracted PLANTAR FASCIA
Weakness in TIBIALIS ANTERIOR cf PERONEUS LONGUS
-> FIXED PLANTAR FLEXION OF FOREFOOT

Question 1

What is pes cavus?

Answer 1

High arches foot often with heel varus ( cavovarus)

Question 2

What are the causes of pes cavus?

Answer 2

NEUROMUSCULAR 
Unilateral - tethered spinal cord
                   Spinal cord tumours
Bilateral- CHARCOT MARIE TOOTH
               FRIEDREICH 'S ATAXIA
               CEREBRAL PALSY
                POLIO
IDIOPATHIC
TRAUMA- compartment syndrome, Malunion of fracture talus, crush injury

Question 3

What would a pt complain of?

Answer 3

Pain and calluses - 1s MT, 5th MT, medial heel

Question 4

What test would you perform on his pt feet?

Answer 4

COLEMAN BLOCK TEST

Question 5

What is the COLEMAN BLOCK TEST?

Answer 5

Woden. Lock placed laterally to 1st ray , mt head off it. Test of foot on it

Question 6

What does the test indicate?

Answer 6

Whether the deformity if drive by forefoot- plantar flexes first ray
If the hind foot passively corrects from varus to valgus the deformity is forefoot driven

Question 7

How does a corrective hindfoot change management ?

Answer 7

Surgically a dorsal metatarsal dorsiflexion osteotomy is indicated

Question 8

If the Coleman block test is negative with no correction of hindfoot valgus what is the tx?

Answer 8

A LATERAL CALCANEAL CLOSED WEDGE OSTEOTOMY is required as well as. DORSIFLEXION OSTEOTOMY OF 1st METATARSAL

Question 9

If severe rigid deformity what would be tx?

Answer 9

Surgical TRIPLE ARTHRODESIS

COnsx- FULL LENGTH, semi rigid orthotic with depression of first ray and LATERAL WEDGE