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Pes Planus and Pes Cavus
Pes Planus and Pes Cavus
A) PES PLANUS:
a) DEFINITION: A POSTURAL DEFORMITY OF THE FOOT WHERE THE MEDIAL
LONGITUDINAL ARCH OF THE FOOT IS REDUCED, CAUSING THE MEDIAL BORDER OF THE
FOOT TO CONTACT THE GROUND WHEN A PERSON IS STANDING.
IT HAS TWO TYPES: CONGENITAL AND ACQUIRED.
b) ETIOLOGY:
i. HEREDITARY
ii. WEAK ARCHES OF THE FOOT
iii. PREVIOUS FOOT/ ANKLE INJURY
iv. EXCESSIVE FOOT STRESS
v. GENERAL MUSCLE HYPOTONIA
vi. UNSUITABLE FOOTWEAR
vii. HYPER-LAXITY SYNDROME (MARFAN'S SYNDROME)
viii. TARSAL COALITION (RIGID AND PAINFUL FLAT FOOT)
ix. TIBIAL POSTERIOR DYSFUNCTION
c) CLINICAL FEATURES:
MEDIAL ARCH IS OBLITERATED, NAVICULAR BONE IS PROMINENT AND FINGERS
CANNOT BE INSERTED UNDER THE ARCH AND SOLE OF FOOT. THE AREA OF WEIGHT
BEARING INCREASES AND MAY SHOW INCREASED CALLOSITY.
IT HAS THREE TYPES:
FLEXIBLE: ON WEIGHT BEARING, NORMAL ARCH APPEARS.
RIGID: COULD BE SEMI-RIGID OR FIXED. DURING NORMAL WEIGHT BEARING,
NORMAL ARCH DOESN’T APPEAR.
STATIC: MOST COMMON ONE; DUE TO FAULTY POSTURE, EQUINUS DEFORMITY
OR VARUS DEFORMITY.
ALOYSIUS RODRIGUES
BPT YEAR III
ROLL NO: 06
d) SYMPTOMS AND SIGNS:
A) CHILDREN: GENETIC MUSCULOSKELETAL CONDITIONS LIKE DYSPREXIA,
LIGAMAENTOUS LAXITY OR HYPERMOBILITY, FOOT PAIN IN HEEL OR ARCH OF FOOT.
e) RADIOLOGICAL FEATURES:
A) CHILDREN: LATERAL X-RAY WITH C-SIGN WHICH IS A BONY BRIDGE BETWEEN TALAR
DOME AND SUSTENTACULUM TALI IN COMBINATION WITH A PROMINENT INFERIOR
BORDER OF THE SUSTENETACULUM TALI.
B) PES CAVUS:
b) ETIOLOGY:
i. MUSCULAR DYSTROPHIES (DUCHENNE, BECKER)
ii. CORD LESIONS (POLIOMYELITIS, TETHERED CORD, SYRINGOMYELIA,
DIASTOMATOMYELIA)
iii. NEUROPATHIES (HMSN I, HMSN II)
iv. CEREBRAL DISORDERS (CEREBRAL PALSY, FRIEDREICH'S ATAXIA)
ALOYSIUS RODRIGUES
BPT YEAR III
ROLL NO: 06
v. VOLKMANN'S ISCHEMIC CONTRACTURE.
CLASSIFICATION OF PES CAVUS:
IDIOPATHIC
SECONDARY
TRAUMA
OTHERS
d) SYMPTOMS AND SIGNS: PAIN FELT AT METATARSAL HEAD OR OVER TOES WHERE
SHOE PRESSURE IS MOST MARKED, CALLOSITIES APPEAR AT SAME SIGHT AND WALKING
TOLERANCE IS REDUCED, MUSCLE WEAKNESS AND JOINT INSTABILITY.
REFERENCES:
TEXTBOOK OF ORTHOPEDICS BY JOHN EBNEZAR – 4 TH EDITION
CAMPBELL’S OPERATIVE ORTHOPEDICS – 11TH EDITION
BAILEY & LOVE’S SHORT PRACTICE OF SURGERY – 27 TH EDITION
CLINICAL ORTHOPEDIC REHABILITATION – 4TH EDITION
REVIEW OF ORTHOPEDICS BY MARK MILLER – 6 TH EDITION
APLEY & SOLOMON’S SYSTEM OF ORTHOPAEDICS AND TRAUMA – 10 TH EDITION
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