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Review
. 2021 Jun 28;6(6):510-517.
doi: 10.1302/2058-5241.6.210021. eCollection 2021 Jun.

How to manage pes cavus in children and adolescents?

Ignacio Sanpera  1 , Sandra Villafranca-Solano  1 , Carmen Muñoz-Lopez  1 , Julia Sanpera-Iglesias  2
Affiliations
Review

How to manage pes cavus in children and adolescents?

Ignacio Sanpera et al. EFORT Open Rev. .

Abstract

Pes cavus in its different forms is not a pathological entity, but rather the manifestation of multiple diseases.Cavovarus, a form of cavus foot, should never be considered a physiological deformity. A neurological condition should always be excluded.The evolution of pes cavovarus is unpredictable because of the large number of conditions involved in its aetiology, as well as their variable degree of expression. About 66% of cavovarus feet are the result of subtle neurological diseases, which only become evident later in life.Although surgery may not change quality of life, recent studies suggest that it may improve foot posture and reduce walking instability.The aim of treatment is to preserve a painless, plantigrade, mobile foot. Management consists of correcting bone deformity while preserving movement, and the wise use of rebalancing techniques. Arthrodesis should only be a salvage procedure. Cite this article: EFORT Open Rev 2021;6:510-517. DOI: 10.1302/2058-5241.6.210021.

Keywords: cavovarus; cavus; children.

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Conflict of interest statement

ICMJE Conflict of interest statement: The author declares no conflict of interest relevant to this work.

Figures

Fig. 1
Fig. 1
Coleman test: block placed under the lateral border of the foot and heel, while the medial side of the floor is lying on the floor. Observe the correction of the heel varus.
Fig. 2
Fig. 2
Standing lateral film of the foot. Note the posterior location of the lateral malleolus and the distorted image of the talar dome, indicating external rotation deformity at the level of the ankle.
Fig. 3
Fig. 3
Lateral standing film of a cavovarus foot. (1) indicating the calcaneal pitch angle, (2) indicating the abnormal Meary angle.
Fig. 4
Fig. 4
Standing AP film, in a severe pes cavovarus. Note the abnormal relationship of the talus and 1MTT. Notes. AP, anteroposterior; 1MTT, first metatarsal.
Fig. 5
Fig. 5
Severe cavovarus deformity treated by Tarsal osteotomy.
Fig. 6
Fig. 6
(a) Girl aged 10 years with severe pes cavus, standing lateral X-ray before surgery. (b) The same girl treated by dorsal hemiepiphysiodesis of the 1MTT and fascial plantar release four years after the initial procedure. Note. 1MTT, first metatarsal.
See this image and copyright information in PMC

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