Cavus (High Arch Feet)
A cavovarus foot deformity is a condition in which the foot has an abnormally high arch and the heel slants inward. The high arch feet places more weight than normal on the ball and heel of the foot during walking or standing, causing pain and instability. Usually present in childhood and often affecting both feet, a cavovarus foot deformity typically worsens over time and frequently requires surgical repair.
Causes of Cavovarus Foot Deformity
A cavovarus foot deformity may occur as a congenital defect, sometimes combined with another foot abnormality such as a club foot. The anomaly may also be the result of:
- Neurological disorders like cerebral palsy or muscular dystrophy
- Charcot-Marie Tooth disease, a hereditary neuropathy
- Stroke or spinal injury
- Spinal tumor
- Traumatic injury, such as a severe fracture or burn
A certain number of cases are idiopathic, meaning they occur for unknown reasons.
Symptoms of Cavovarus Foot Deformity
The exceptionally high arches of a cavovarus foot cause abnormal pressure on the bones of the forefoot, known as the metatarsals, which can result in pain, especially on the heel, ball or side of the foot. The high arches also effectively shorten the foot, making it problematic for patients with this condition to find shoes that fit properly.
Apart from the noticeably high arch of the foot and the concomitant discomfort it produces, other symptoms of the condition may include:
- Foot weakness and fatigue
- Claw toes
- Foot instability
Because of the abnormal pressure on the foot and ankle, patients with cavovarus foot deformity are also prone to ankle sprains and stress fractures.
Diagnosis of Cavovarus Foot Deformity
In order to diagnose a cavovarus foot deformity, a full evaluation is performed, including medical history and physical examination. The patient will be examined in both a standing position and a supine posture (lying down). In addition, the patient’s gait will be carefully observed. In many cases, X-rays, muscle tests, MRI and CT scans may also be administered.
Treatment of Cavovarus Foot Deformity
There are several treatment options for a cavovarus foot deformity, depending on the severity of the individual case. The goal of all such treatments is to relieve pain and improve stability. When the condition is mild, patients may achieve sufficient pain relief and support through the use of orthotics, orthopedic shoes, foot or ankle braces. If the condition does not improve or worsens, however, surgical intervention may be necessary.
The three surgical techniques employed to correct the muscle imbalance of cavovarus foot deformity are osteotomy (removal or realignment of a bone), tendon transfer, or arthrodesis (bone fusion).
Robert Spencer, DPM
Nitza Rodriguez, DPM
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