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VOLUME 3 ISSUE 7

THE RESIDENCY INTERVIEW


CFAC MEDICAL & SURGICAL RE P O R T
JANUARY

PES CAVUS
INSIDE THIS ISSUE:

Pes cavus was first identi- Posterior cavus is excessive


TYPES OF
fied as a specific foot de- plantarflexion proximal to RADIOGRAPHIC ANGLES
CAVUS
DEFORMITY formity by Little in 1853. It Chopart’s joint. Meary’s angle: Bisection of the
COMBINED can be classified into either 1st met and bisection of the
Posterior cavus is seen fre-
CAVUS anterior cavus, posterior talus (intersects at the apex of
quently due to gastrocsoleus the deformity)
cavus, or combined cavus
paresis/paralysis such as
RADIOLOGY foot. Hibb’s Angle: Bisection of the
observed in patients with
1st met and long axis of the
Anterior cavus can be fur- poliomyelitis.
calcaneus (intersects at the
SURGERY ther subdivided into 4 types: apex of the deformity)
1. Metatarsus cavus– ex-
cessive plantarflexion at COMBINED CAVUS
Lisfranc’s joint 1. Cavovarus– triplanar, re-
calcitrant, lateral ankle
2. Lesser tarsus cavus–
instability, lateral column
excessive plantar flexion
gait
over lesser tarsal bones
BRYAN 2. Calcaneocavus– sagittal
CALDWELL, CFAC patient with Post-polio
3. Forefoot cavus– Exces- plane only, can affect me-
DPM
sive plantarflexion at dial and lateral columns syndrome
Chopart’s joint
3. Cavovalgus– rare, due to
4. Combined anterior MTJ compensation
SPECIAL POINTS
OF INTEREST:

• A characteristic midfoot
bump is seen clinically REVIEW
at the apex of the de-
formity with anterior
BONE SURGERY displacement osteotomy for SOFT TISSUE SURGERY
cavus
anterior cavus
1. Dwyer– lateral closing 1. Plantar fasciotomy
• The Coleman lateral wedge osteotomy of the 4. Akron Midtarsal Dome Os-
block test differentiates calcaneus used to treat a teotomy– Biplane osteotomy 2. Steindler Stripping
a fixed heel varus from fixed heel varus in which a 1 cm lateral
a varus secondary to a curved wedge of bone is 3. Hibbs– EDL transferred to
2. Cole Midtarsal Osteotomy– removed
plantarflexed 1st ray V midfoot dorsiflexory 3rd cuneiform
wedge osteotomy for ante- 5. Dorsiflexory Osteotomy of the
• Soft tissue procedures rior cavus 1st Metatarsal 4. Jones– EHL transferred to
are reserved for chil- 1st met head
dren 5-10 years old 3. Japas Midtarsal Osteot- 6. Triple arthrodesis
omy– A midfoot V plantar 5. Tendon transfers