Pes cavus Flashcards
Describe the coleman block test
Patient stands on block that eliminates plantarflexed first ray or forefoot valgus. If the heel returns to vertical then the deformity is flexible.
Hibbs angle
Bisection of calcaneus and 1st met. Shows the apex of deformity. Over 130 degrees is normal. Less than 130 is pes cavus.
Jones tenosuspension
Transfer of EHL to the head of the 1st met from medial to lateral. Correction of contracted 1st digit. Dorsiflex the 1st met
Hibbs tendon transfer
Transfer EDL tendon stump to the lateral midfoot to correct contracted less digits
Split tibialis anterior tendon transfer
Transfer TA to lateral midfoot to create an eversion force. Often the TA is transferred to the PT
Cole Osteotomy
Dorsal closing wedge through the entire midfoot. The two cuts are proximal and distal to the NJ joints
Japas osteotomy
Midfoot V osteotomy through the apex of the cavus deformity. Medial arm exits through the first met and the lateral arm exits through the cuboid.
Dwyer osteotomy
Lateral closing wedge osteotomy of the calcaneus. This shifts the posterior aspect laterally and which creates a valgus motion
Posterior cavus foot is caused by…
Weakness of the Achilles tendon
Anterior cavus is caused by…
Weak intrinsic muscles and retraction of the plantar soft tissue
What are typically associated with claw toes?
Anterior cavus foot
A flexible deformity as determined by the coleman block test mean what type of surgery is indicated
Forefoot surgery
Possible a dorsflexion wedge of the first met
Cavus foot conservative treatment
Physical therapy
Casting in progressive abduction
Insoles
Custom sheos
Indication for a plantar release fasciotomy
Mild and flexible pes cavus
Indication for a tendon transfer
Flexible deformity
