Flashcards in Pes cavus Deck (10):
What is pes cavus?
High arches foot often with heel varus ( cavovarus)
What is its pathology?
A contracted PLANTAR FASCIA
Weakness in TIBIALIS ANTERIOR cf PERONEUS LONGUS
-> FIXED PLANTAR FLEXION OF FOREFOOT
What are the causes of pes cavus?
Unilateral - tethered spinal cord
Spinal cord tumours
Bilateral- CHARCOT MARIE TOOTH
FRIEDREICH 'S ATAXIA
TRAUMA- compartment syndrome, Malunion of fracture talus, crush injury
What would a pt complain of?
Pain and calluses - 1s MT, 5th MT, medial heel
What test would you perform on his pt feet?
COLEMAN BLOCK TEST
What is the COLEMAN BLOCK TEST?
Woden. Lock placed laterally to 1st ray , mt head off it. Test of foot on it
What does the test indicate?
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
How does a corrective hindfoot change management ?
Surgically a dorsal metatarsal dorsiflexion osteotomy is indicated
If the Coleman block test is negative with no correction of hindfoot valgus what is the tx?
A LATERAL CALCANEAL CLOSED WEDGE OSTEOTOMY is required as well as. DORSIFLEXION OSTEOTOMY OF 1st METATARSAL