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PubMedDate not supplied

Cavus foot in cerebral palsy.

In the child between 4 and 12 years of age presenting with cavus deformity associated with spastic cerebral palsy, symptomatic feet may be improved by soft tissue release of plantar structures followed by appropriate tendon lengthenings or transfers and good cast correction. It is more common for the deformity to present in teenage patients, however, with a more rigid foot usually complicated by some degree of varus and equinus. In these situations, triple arthrodesis is often necessary and is a predictable procedure for correction and stabilization of the deformity.

Adolescent↗
PubMed1994

The modified Robert Jones tendon transfer in cases of pes cavus and clawed hallux.

This is a retrospective study of the modified Robert Jones tendon transfer in 24 patients and 28 feet. The main indication for the procedure was to correct symptoms related to clawing of the hallux in seven patients, relieve pressure under the head of the first metatarsal in 13 patients, and treat for both symptoms in three patients. One patient had diffuse ache in the arch. Fifteen patients had idiopathic cavus feet, of whom five had associated spina bifida occulta. The remainder had a variety of different etiologies including cerebral palsy, head injury, brain abscess, and spinal cord tethering. Postoperative follow-up ranged from 7 months to 33 years with an average of 5 years and 6 months. The modified Robert Jones tendon transfer was shown to be effective in relieving symptoms related to clawing of the hallux in 90% of patients but was not reliable in curing pain under the first metatarsal head, with success in only 43% of patients. In three patients, pain under the metatarsal head was relieved initially but recurred by 18 months. Complications were frequent. Six patients developed pain under the tip of the hallux postoperatively.

Adolescent↗
PubMed1993

Work in progress CAVUS: transcaval ultrasonography of abdominal organs. Preliminary results.

Endoluminal sonography using tiny transducers (20 MHz) has found wide application in various fields of investigation. We have applied the same technology to the assessment of abdominal organs using the transcaval route (CAVUS). Normal vessels and both normal and dilated bile ducts were displayed. Although the procedure is simple and safe, and the images produced are excellent, to be useful clinically, microtransducers (6 or 7 MHz) will have to be developed. This technique holds much promise, and further miniaturization will allow greatly expanded use of endoluminal approaches.

Abdomen↗
PubMed2000

Treatment of the cavus foot. Deformity in the pediatric patient with Charcot-Marie-Tooth.

The orthopedic management of foot and ankle problems associated with Charcot-Marie-Tooth disease is becoming better understood but is still evolving. It is now known that Charcot-Marie-Tooth disease should be considered a spectrum of neurologic disorders with variable inheritance patterns, clinical course, and severity of deformities. Over half of the patients with Charcot-Marie-Tooth disease develop foot and ankle problems of which the cavovarus deformity is by far the commonest. Other clinical problems include weakness, parathesias, pain, and an unsteady gait. The cavovarus deformity seems to develop from a relative imbalance between the peroneus longus and tibialis anterior muscles and from an imbalance between the tibialis posterior and peroneus brevis muscles. Treatment of the cavovarus foot deformities should be individualized for each patient after careful preoperative evaluation. Surgery using a variety of soft tissue procedures and osteotomies seems to be the treatment of choice for the progressive cavovarus deformity in younger patients. For a patient who has severely rigid deformities a triple arthrodesis may be the only option but is considered by most to be a salvage procedure. It always should be kept in mind that Charcot-Marie-Tooth disease is a progressive neurologic disorder and the deformities can progress despite surgical intervention. Even though the results of treatment in this disease are difficult to evaluate because of the wide [figure: see text] spectrum of disease, it seems reasonable to believe that early surgical intervention in the flexible cavus foot can restore normal foot posture and help prevent or delay the need for more extensive bony procedures.

Adolescent↗
PubMed1975

Cavus deformity of the foot after fracture of the tibial shaft.

Twenty-three cases of claw foot with limited talocrural and subtalar mobility were the result of muscle contracture of the leg after tibial-shaft fracture. A roentgenographic study including arteriography was performed. It was concluded that the typical short cavus foot is due to fibrous contracture of the muscles in the deep posterior compartment caused by vascular damage, swelling in the deep posterior compartment, or severe muscle laceration. On physical examination the distance between the lateral malleolus and the Achilles tendon was shortened in comparison with the sound side in all cases. This was found to be caused by dorsiflexion in the talocrural joint coincident with adduction in the mid-tarsal joint. The angulation of the foot forced the patients to rotate the leg outward in order to get the feet in parallel position for walking. This deformity could be misinterpreted as an inward malrotation of the tibial fracture. In severe cases a derotating three-dimensional wedge osteotomy of the distal part of the tibia was performed with promising results.

Adolescent↗
PubMed1976

[Anterior tarsectomy for pes cavus: indications and long term results].

The authors have reviewed 48 cases of pes cavus treated by anterior tarsectomy with an average follow-up of two years. The clinical, anatomical and radiological features of the condition are described. The results were satisfactory in two-thirds of the cases. Failures were related to unsatisfactory indications such as children under thirteen, progressive neurological disease or associated impairment of the ankle joint (arthritis, dislocation). The indications for the procedure are discussed and compared with those for Dwyer calcaneal osteotomy, triple arthrodesis, soft tissue operations (Steindler) or resection of the metatarsal heads.

Adolescent↗
PubMed1977

[Osteotomy of the calcaneus for pes cavus in childhood].

Osteotomy of the calcaneus (Dwyer procedure) was performed in 14 children (26 feet) aged between 5 and 15 years. On four occasions it was associated with an osteotomy of the first metatarsal and on three occasions with tarsectomy. The technique is described and the results are analysed. The authors conclude that the results were good in children under the age of 10 whilst the feet were still supple. In children over the age of 10, in whom the feet were more rigid, the gait was improved but the cavus deformity was not improved. The best age for operation is between 6 and 10 years.

Adolescent↗
PubMedDate not supplied

A modification of the Hibbs tenosuspension for flexible cavus deformity.

The authors present a modification of the Hibbs tenosuspension for the correction of clawtoes associated with flexible cavus deformity. A release of the plantar fascia is performed along with the procedure. The major advantages offered by this procedure are the ease in which it can be performed, the vector of the extensor digitorum longus tendon at the ankle is not disrupted, and the only osseous work necessary is digital arthroplasty.

Clubfoot↗
PubMedDate not supplied

Peroneus tertius reconstruction for flexible clawtoes associated with cavus deformity: a preliminary report.

Numerous procedures and techniques are used to correct clawtoe deformity. This paper reports on a new method of correcting clawtoe deformity surgically. Treatment of this condition is not new, and a survey of the literature is offered initially. The theory behind the tendon transposition is discussed and symptoms associated with this deformity are outlined. Variations of this new procedure are listed and illustrated clinically. The authors recommend the peroneus tertius redirection and/or reconstruction procedure as the most adequate way of reducing clawtoe deformity associated with flexible cavus foot.

Adolescent↗
PubMed1981

Pes cavus: the deformity and its etiology.

Pes cavus is present when the forefoot is in a plantarflexed position in relation to the rearfoot. In the majority of patients, the deformity is caused by a neurologic disorder; however, the condition may also result from infection or trauma. It is necessary to determine the etiology in order to plan effective treatment.

Clubfoot↗
PubMed1978

Repair of calcaneal varus and cavus.

Calcaneal varus or calcaneal cavus alone can be readily corrected, and the surgical procedure is not technically difficult. The author states that if the four basic points he describes are followed, good results will be obtained, and the osteotomy will heal in the desired position without incident. If other osseous deformities of the foot are involved, the deformities must be considered separately and in relation to each other, and other procedures may be necessary.

Adult↗
PubMed2001

Combined calcaneal and metatarsal osteotomies for the treatment of cavus foot.

Cavovarus foot can be painful and disabling owing to deformity and instability. A method of surgical correction is presented with osteotomies of the forefoot and the hindfoot. The technique avoids arthrodesis while preserving joint motion, lowering the height of the arch, and correcting varus and adductus deformity. Increased ankle stability, elimination of the risk of stress fracture, decreased pain are expected outcomes.

Calcaneus↗