Cavus foot What is distraction osteogenesis?
a condition where the arches in the foot are significantly higher than a normal arch. This causes the heel to point inward and the toes to flex. Children with this condition typically develop it slowly from the time they begin to walk until 10 years old. Most often this condition occurs in conjunction with another musculoskeletal or nervous system disorder.
Most cases of high arches are associated with nervous-system disorders. The conditions that can cause high arches include Cerebral palsy, Spina bifida, Muscular dystrophy, Polio, Stroke, Charcot-Marie-Tooth disease, Spinal cord tumor. The cause of high arches cannot be determined in about one in five instances. These cases are called idiopathic, meaning the condition arises from an unknown or uncertain cause.
Symptoms vary with degree of deformity, pain in the side of the foot and the metatarsals. Calluses on the plantar aspect of the foot. Instability of the ankle. Neuropathies may be accompanied by neuropathic pain. With progression, deformity and rigidity become more severe. This can lead to overload of the lateral side of the foot and even to stress fractures of the fifth metatarsal. Peroneal tendinopathy, Achilles tendon disorders, plantar fasciitis and ankle impingment are more common. A spinal tumour should be suspected in any patient with new unilateral presentation, without previous trauma.
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
Your podiatrist may use some external devices to stabilize your foot, and provide support for your extra-high arches. These devices may include orthotics (which are prescription shoe inserts specially designed for you, braces (worn outside the foot, these will help keep your foot and ankle stable), and special shoes (usually ones with high tops and wide bases to add stability and support). The podiatrist may also treat secondary symptoms, trimming calluses or suggesting the use of pads to reduce pressure on certain areas of your foot.
Ideally, surgeons should first repair the source of the traumatic event such as the ankle instability or peroneal tear in order to stabilize the laxity about the ankle and subsequently judge the level of deformity in the foot. For example, a varus talus position caused
by ankle instability will often make the cavus foot position look worse prior to repair of the lateral collaterals than after repair of the collaterals. After repositioning and stabilizing the talus, one can better judge the varus of the heel and first metatarsal position.