Cavovarus foot – Neurological foot disease


Cavovarus foot can be a difficult problem. It is much less common to see a patient with a high arch with leg pain than a patient with a low arch with leg pain. As a result, high-arched legs are treated less often or may be less understood by the common foot level.

In addition, muscular dystrophy has been associated with high arch legs and can lead to muscle imbalance problems that make the high arch leg more difficult to diagnose and treat. Therefore, let’s take a closer look at the treatment and treatment options of the high bow.

κοιλοποδια αντιμετωπιση θεραπεια αιτια και συμπτωματα

Patients with symptomatic legs with a high arch often experience pain in the lateral spine, instability of the lateral ankle, and pain below the ball of the foot, especially under the first metatarsal bone.
Problems such as plantar fasciitis can also occur with flexible high arch legs as the arch stretches during the gait cycle, causing the fascia to stretch. Patients usually feel like they are falling on the outside of the ankle and may even find swelling and pain in the side leg and ankle. Severe cases can even lead to lateral fractures.

What to look for at diagnosis

The diagnosis of symptoms is made by conducting a history and physical in combination with diagnostic tests. It is important to consider a family history of high arches and any symptoms of muscular dystrophy in the family.

The type of pain and what causes the pain to start is also important to consider.
For example, patients who experience pain with walking compared to pain only when running may need more aggressive treatment than patients who only have pain with high-impact exercise. Examining muscle groups and muscle strength is important. In addition, pain along the perineal tendons may be a sign of a tear tendon. This can lead to a leg cavity as a posterior tibial tendon dysfunction.Lateral ankle instability can also lead to a foot position of the foot as the ankle deviates to an oblique position due to the looseness of the ankle lateral ligaments.

Finally, a first metatarsal with a plantar form or a heel with such a problem can lead to a stable cavity position due to structural deformity.
It is rare to see a deformed anterior cavity of all metatarsals, but we must also consider this possibility. In general, the first radiation falls very often from all metatarsals.

Treatment

Conservative care is extremely successful at the foot of the high bow.
An orthotic with a high heel flange and a secondary metatarsal incision can balance the foot.
Often, the first irradiation is pelvic and the cessation of the first metatarsal head is necessary to balance the front foot.
In severe cases of ankle instability, an orthotic leg at the ankle
or a custom ankle brace can be helpful in balancing the foot and ankle. Examination of the first irradiation should also be part of the support process.

In severe cases of cavovarus foot, surgery is often required. The main concern of surgical planning is the cause of deformity of the cavovarus foot. Examine if it is a structural deformity or caused by an underlying traumatic event, such as a tear tendon or ankle instability.

In addition, whether in a structural or traumatic case, it is important to consider whether the cavovarus foot comes from only a first plantar flexion radius, only a plaster cast, or a combination of the two deformities. After reviewing all the information, one can plan surgery.

Ideally, surgeons should first repair the source of the traumatic event, such as ankle instability or peritoneal tear, in order to stabilize the relaxation around the ankle and then judge the level of deformity in the foot. For example, an injury instability caused by ankle instability will often make the position of the cavity foot appear worse before the collateral repair than after the collateral repair. After repositioning and stabilizing the ankle, one can better judge the heel vein and the first metatarsal position.

Ankle fixation procedures often occur through a primary ankle lateral ligament repair or Brostrom procedure. The surgeon will need to correct both the anterior and lateral ligaments of the ankle in order to fully stabilize the ankle.



Dr Badekas Athanasios


Athanasios Badekas is the Scientific Officer of the Orthopedic Department of the ORTHO REHAB CENTER, which is housed in the center of Glyfada. Our space, recently completely renovated, has been created in such a way as to meet the needs of our doctors and to offer a friendly and functional environment to our patients.




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