CHAPTER 54
Pes Cavus and Cavovarus
Introduction/Etiology/Epidemiology
• Pes cavus is a high-arched foot.
• Pes cavovarus is a high-arched foot with a plantar flexed first ray, forefoot pronation or adduction, and a variable degree of hindfoot varus.
• The high arch is caused by tight plantar fascia and variable weakness of the foot intrinsic muscles, peroneals, or anterior tibialis.
• Pes cavus and cavovarus are seen usually in children older than 3 years.
• These conditions may be idiopathic, but a neurogenic cause is eventually identified in up to 66% of patients with pes cavus or pes cavovarus. Neurologic etiologies include central nervous system abnormalities, spinal abnormalities, peripheral neuropathies, and isolated nerve injury (Box 54-1).
Box 54-1. Etiology of Pes Cavus and Cavovarus
| Neurologic—no. 1 cause; estimated at about 66% |
• Charcot-Marie-Tooth disease |
• Friedreich ataxia |
• Roussy-Lévy syndrome |
• Poliomyelitis |
• Cerebral palsy |
• Dejerine-Sottas hypertrophic interstitial neuritis |
| Congenital |
• Spina bifida |
• Talipes equinovarus |
• Myelodysplasia |
• Clubfoot |
Iatrogenic |
• Post surgery or trauma – Peroneal nerve injury – Weak anterior muscles – Overpowering posterior muscles |
Infection |
