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At least 19 recordsLinked to original sources
PubMed1979

Pes cavus and claw toes deformity in patients with spinal cord injury and multiple sclerosis.

Patients with spinal cord injury or multiple sclerosis were surveyed for the presence of extreme foot deformities and spasticity. Pes cavus and claw toes were found in eight of 80 spastic spinal cord injury and two of 20 multiple sclerosis patients. Pes cavus and claw toes were not found in 29 flaccid spinal cord injury patients. Pes cavus and claw toes were associated with flexor reflexes which could be elicited by pin prick proximal to the knee, suggesting extreme spasticity--and by low excitatory thresholds for the anterior tibialis as indicated electromyographically. Complications of severe spasticity associated with spinal cord injury and multiple sclerosis include pes cavus and claw toes, mediated in part by spasms of the anterior tibialis.

Adult↗
PubMed1976

Peroneus longus tendon lengthening as an adjuvant measure in cavus foot surgery.

Lengthening of the peroneus longus tendon is very important when performing cavus foot surgery. This tendon directly affects all three components (varus heel, increased arch height, and forefoot adduction) of the idiopathic cavus foot which can be accounted for by increased strength and activity of the peroneus muscle. The deforming force is removed or weakened according to the degree, duration and rigidity of the cavus foot by lengthening or transferring the tendon.

Foot↗
PubMedDate not supplied

The present status of the problem of pes cavus.

Notable historical aspects relating to the etiology and treatment of pes cavus have been critically examined. The characteristic features of the deformity are described and an explanation offered for the mechanism of their production. Although its etiology remains uncertain, a study of the literature and a great deal of clinical material has established certain well supported conclusions regarding the etiology and pathology of the condition. Certain aspects of cerebral palsy serve to strengthen impressions of earlier authors that the primary center of origin of pes cavus lies somewhere in the central nervous system. Localized foci of partial damage lying adjacent to tracts of nerve cells more seriously affected by a neurological disease could emit irritating stimuli capable of producing degrees of over-action of the invertor muscles varying from obvious spasm to clinically undetectable increase in muscle tone. Biral or other factors which stop short at creating nothing more than such a focus of irration could explain the insidious onset of the deformity in the idiopathic group. Over-action of invertor muscles for one reason or another, including ischemia, is almost certainly responsible for initiating the deformity, though primary contracture of the plantar fascia could possibly do so. With the appearance of supination of the heel, the calcanean tendon becomes an active invertor adding its force to that of the plantar fascia to produce structural varus of the calcaneum. Contracture of the plantar fascia and supination of the heel are regarded as features of major importance. Correction of the latter can be achieved more effectively by suitable osteotomy than by subtaloid fusion, which is regarded with great disfavor. Conservative treatment consists of exercises and shoe appliances. Surgical correction is based on calcanean osteotomy and plantar fasciotomy supplemented where necessary by suitable tendon transplantations, correction of clawing of the toes, and tarsal or metatarsal wedge resections. Preservation of the midtarsal subtaloid joint complex is essential. With the heel correctly aligned the degree of improvement to be expected in the forefoot deformity is such that any structural operation on it should be deferred until a fair period of walking has been tried.

Adolescent↗
PubMed1977

Osteotomy of the metatarsals for pes cavus.

Described is a surgical procedure for pes cavus which includes multiple osteotomies of the metatarsals, usually combined with Steindler fasciotomy and extensor tenotomy. This method permits the correction of the cavus deformity and preserves the length of the foot without disturbing any joint. A total of 11 patients with 14 procedures have been followed up for an average of more than three years. Results of 12 of the 14 operations were favorable according the the criteria used.

Adolescent↗
PubMed1979

[Plantar release in the treatment of pes cavus in childhood. Technique and indications (author's transl)].

The authors have operated on forty instances of pes cavus in children. Ten were idiopathic, nine poliomyelitic, five hemiplegic and five as a sequel of club foot. Others cases were of various neurological cause. In all cases, the plantar fasciae and ligaments were released; the technique of this procedure is fully described. In a number of cases, soft tissue release was associated with an osteotomy of the first metatarsal, a transplant of the extensor hallucis longus to the neck of the first metatarsal, an osteotomy of the calcaneus or various muscle transplants depending on the etiology of the cavus deformity. The results are analysed as are the complications. They were satisfactory in 66 p. 100 of cases. It is concluded that plantar release procedures may either avoid arthrodesis or may lead to it later but with the foot in a more satisfactory condition.

Adolescent↗
PubMed1977

Mechanism and reconstruction of pes cavus.

Many important factors are involved in the surgical treatment of pes cavus. Among these factors are the location of the deformity--frontal, sagittal, or transverse planes--and whether there is an associated muscle weakness. Biomechanical analysis will help to determine whether the cavus foot is rigid or nonrigid and how it functions. Neurologic and radiologic tests must also be used to determine the type of operative procedure required for correction of the deformity.

Biomechanical Phenomena↗
PubMed1978

Zosteriform lentiginous naevus with ipsilateral rigid cavus foot.

A patient is presented with a rigid cavus deformity associated with a painful linear keratotic lesion on the lateral plantar border. A unilateral zosteriform lentiginous naevus is found on the same side as the foot deformity. Electrodiagnostic evaluation suggests the presence of a non-specific neuromuscular process on the affected side. This association has not previously been reported.

Adult↗
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↗
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↗
PubMed1977

The cavus foot.

Explore the source record for details and available documents.

Adolescent↗
PubMed1979

Multiple endocrine neoplasia, type 2b: phenotype recognition; neurological features and their pathological basis.

Sixteen patients affected with multiple endocrine neoplasia, type 2b (MEN 2b), were evaluated by clinical, neurological, nerve conduction and electromyographic, and postmortem examinations. Eight of the 11 patients examined clinically had symptoms: 5, neurogenic constipation; 1, failing vision due to hypertrophied corneal nerves; 1, neuromuscular symptoms and pes cavus; and 1, facial disfigurement. Expression of the dominantly inherited MEN 2b gene is more variable than previously known. When neuromuscular findings are present alone, the features may be those of peroneal muscular atrophy. Because 10 of the 11 patients had sufficiently full expression of the dominantly inherited gene--"Marfanlike" body build, full and fleshy lips, whitish yellow nodules (neuromas) on the tip and edges of the tongue, pes cavus, or peroneal muscular atrophy--the presence of MEN 2b was recognized and a search for the usually associated medullary thyroid carcinoma was instigated. In addition to the recognized involvement of autonomic nerves, we have confirmed that somatic motor and senory neurons may be involved. Findings at postmortem evaluation indicate that symptoms can be attributed to neuroma formation: a characteristic adventitious plaque of tissue composed of hyperplastic, interlacing bands of Schwann cells and myelinated fibers overlay the posterior columns of the spinal cord.

Adolescent↗
PubMed1976

Chronic polyradiculoneuropathy of infancy. A report of three cases with familial incidence.

Two siblings and a third child exhibited a syndrome of progressive muscular weakness and wasting, closely resembling Werdnig-Hoffmann's disease. Autopsy of one of the siblings and the third child showed nearly total absence of myelin sheaths in the cranial and spinal nerve roots, relative preservation of axons, and normal neurons in the motor cranial nerve nuclei and anterior spinal gray matter. The mother of the siblings had bilateral pes cavus, and the father of the third child had a sensory-motor polyneuropathy dating to childhood, associated with pes cavus and scoliosis. The disorder in these children and in a few similar cases in the literature shares some features of Charcot-Marie-Tooth disease and the hypertrophic neuropathy of Dejerine-Sottas, but it is difficult to classify as either of these familial neuropathies as presently defined. Elevation of cerebrospinal fluid protein is a useful finding in distinguishing such children from patients with Werdnig-Hoffmann's disease.

Cerebrospinal Fluid Proteins↗