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Abstract
Pes cavus is a high arch that does not flatten with weightbearing \ ith or without intact neurological function, (J:.hss, 1983). A precise radiological definition of pes cavu . i difficult becou e the deformity 1 made up of ’arious component’. A purecavu or abnormall high arch i es entially an equine deformity of the fore part of the foot in relation to the hind foot (Levitt ef al., 1973).
In a plantigrade foot the ole of the foot dorsiflexes to the natural in relation tibia. This i the position in which the foot i normally immobilized, III that po ition weighbearing i evenly eli tributed b tween th heel and metatarsal heads. This relation betw n the foot
ole and th tibia termed the tibioplantar angle. The cavu foot usually non plantigrade with di tributed tibioplantar angle (Jah s, 1983),
Th pectrum of a ociated deformiti ob en ed v ith pes caw rn lude clawing of th to , posterior hind foot deformity contracture of the plautar fa cia, and cock-up deformity of the great toe, which cause increased weighrbearing for the metatar al head and associated metatarsalgia and callu (Levitt, et al., 1973).
TIle etiology of pes cavus can be identified approximately 80 % of time. ause include neuromuscular di .ea e, traumatic pe cavu and re idual clubfoot (Jllllss, 1982), The neuromu CU!lIl’ di ea es, cause muscle imbalance that lead to an de at cl arch. These disease
include Charcot-Marie- Tooth (CMl) disea e, spinal dy raphism, poi -neuriti intraspinal tumors, poliomyeliti cere ral palsy, syringomylia, a patient with a new onset of unilateral deformity \;\, ithout history of truma must be evaluated for spinal cord tumor. The remaining 20 % of cases are idiopathic and non progressive (ROpt’I” 1989).
Multiple theories are proposed for the pathogenesis of pe cavus, Duchenn described intrinsi mu cles imbalanc causing the elevated arch. Other ha e theorized that th extrin i rut! ole call muscle imbalance. Moreover, others believe that a combination of the intrin ic and extrin ric muscles i the cau e of the imbalance (Sabjr, 1982).
TIle pre en tat:i On for patient with ell us feet i quire variable based larg ty 00 the extent of deformity. They can present wi th the lateral foot pain, meratarsalgia i a frequent ymptorn, ankle instabilit can be a presenting symptom specially in patient with hind foot varu and weak peroneu bre i mu cle. Weakness and fatigue can be observed in patients with n uromuseular di ’ease ( ann, 1992).
Evaluation of a patient that present with pes cavus begin with through hi tory and complete examination in attempt to try to determine the etiology (’Vapner, 2000).