The Idiopathic Cavus Foot–Not So Subtle After All

Abbasian, Ali; Pomeroy, Gregory

doi:10.1016/j.fcl.2013.08.004

Cited by 22 publications

(35 citation statements)

References 23 publications

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“…O tratamento cirúrgico voltado apenas para a abordagem das lesões secundárias possuía resultados ruins com alta taxa de recidiva (3) . Após a descrição do pé cavo varo sutil por Manoli e Graham, vários estudos sobre a abordagem em conjunto da deformidade e das lesões associadas em um único tempo foram descritos e mostraram melhores resultados e menores taxa de recorrências (4,8) . Maskill et al (9) avaliaram 13 pacientes com pé cavo varo sutil associados à instabilidade ligamentar lateral ou à tendinopatia dos fibulares pós-traumática.…”

Section: Discussionunclassified

“…Vários autores (1,2,4,9) guiam seu tratamento através do teste de Coleman. Quando o varismo do retropé é corrigido com o teste infere-se que o mesmo é secundário à flexão excessiva do primeiro raio, sendo a osteotomia de extensão do primeiro metatarso suficiente para realinhar o eixo biomecânico.…”

Section: Discussionunclassified

“…Apesar do pé cavo varo ser geralmente associado a doenças neurológicas com alterações grosseiras do eixo biomecânico e desequilíbrios musculares graves, existe uma variante idiopática com varismo e cavismo discretos, flexíveis no teste de Coleman, descrita inicialmente em 2005 por Manoli e Graham como pé cavo varo sutil (PCVS) (3) . O diagnóstico é essencialmente clínico, por se tratar de uma deformidade discreta em que os ângulos medidos nos exames radiográficos estão normais ou com mínimas alterações (4) . Em relação à sua apresentação, existem algumas considerações importantes.…”

Section: Introductionunclassified

“…Por se tratar de uma deformidade discreta com amplo espectro clínico ocasionado por essas lesões secundárias e sem parâmetros diagnósticos objetivos, o PCVS geralmente é negligenciado (3) . O tratamento das lesões secundárias de forma isolada, ou sem a correção adequada da biomecânica, pode evoluir com resultados piores e maior predisposição à recidiva (3,4,7) . O artigo apresenta uma série de casos com o objetivo de avaliar os resultados clínicos do tratamento cirúrgico do pé cavo varo sutil através da osteotomia de extensão do primeiro metatarso e da liberação da fáscia plantar.…”

Section: Introductionunclassified

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Evaluation of the surgical treatment of subtle cavovarus foot

et al. 2018

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RESUMOObjetivo: Série de casos com o objetivo de avaliar os resultados do tratamento cirúrgico do pé cavo varo sutil com osteotomia de extensão do primeiro metatarso e liberação da fáscia plantar. Métodos: Foram avaliados 11 pacientes e 12 pés, com média de idade de 40 anos, acompanhamento mínimo de 12 meses, sendo cinco do sexo masculino e seis do sexo feminino. Todos apresentavam diagnóstico de pé cavo varo sutil, com patologias associadas que não melhoraram com o tratamento conservador e foram submetidos à correção cirúrgica. Os pacientes foram avaliados através do exame clínico, do questionário da American Orthopaedic Foot and Ankle Society Score (AOFAS), da escala visual analógica (EVA) da dor no pré e pós-operatório, da avaliação do grau de satisfação e da correção clínica da deformidade. Resultados: O AOFAS médio passou de 44,4 para 80. A EVA da dor média passou de 8,7 para 2,0 pontos. Sete pacientes classificaram o resultado como excelente, dois pacientes como bom e os outros dois como regular. Dois pacientes tiveram deiscência da ferida operatória, um apresentou uma neuropatia no nervo fibular e um outro metatarsalgia de transferência, todos foram tratados clinicamente com resolução dos quadros. Não houve recidiva da deformidade e das patologias associadas. Conclusão: O tratamento cirúrgico do pé cavo varo sutil através da osteotomia do primeiro metatarso em associação à liberação da fáscia plantar mostrou bons resultados clínicos. Nível de Evidência III; Estudo Retrospectivo Comparativo.Descritores: Pé cavo; Deformidades do pé; Diagnóstico; Tratamento. ABSTRACTObjective: To evaluate, using a case series, the results of the surgical treatment of subtle cavovarus foot with extension osteotomy of the first metatarsal and release of the plantar fascia. Methods: Eleven patients and 12 feet, including five males and six females with a mean age of 40 years and minimum follow-up of 12 months. All patients had a diagnosis of subtle cavovarus foot with associated pathologies that did not improve with conservative treatment and were subjected to surgical correction. The patients were evaluated through a clinical examination, the American Orthopedic Foot and Ankle Society (AOFAS) scale, the visual analog scale (VAS) of pain in the pre-and postoperative period, and assessment of the degree of satisfaction and clinical correction of the deformity. Results: The mean AOFAS score increased from 44.4 to 80. The mean pain VAS score decreased from 8.7 to 2.0. Seven patients rated the result as excellent, two patients as good and the other two as regular. Two patients had dehiscence of the surgical wound, one presented a neuropathy in the fibular nerve, and another presented transfer metatarsalgia; all were treated clinically with resolution of the clinical picture. There was no recurrence of deformities or associated pathologies. Conclusion: Surgical treatment of subtle cavovarus foot through first metatarsal osteotomy in combination with plantar fascia release showed good clinical results. Level of Evidence III; Retrospe...

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Section: Discussionunclassified

Section: Introductionunclassified

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Evaluation of the surgical treatment of subtle cavovarus foot

et al. 2018

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“…This tight space predisposes the nerve to compression by the bursa above the nerve and lumbricalis muscle/tendon arising from the medial aspect of the flexor digitorum longus that runs parallel to the nerve [25, 26]. Furthermore, the plantar declination of the metatarsals in a cavus foot type can increase pressure over the corresponding nerve [27]. Pazzaglia et al reported that 75% of his IMN patients ( n = 12) in an immunohistochemical study had a cavus foot type with forefoot deformity [6].…”

Section: Introductionmentioning

confidence: 99%

The relationship between foot posture index, ankle equinus, body mass index and intermetatarsal neuroma

Naraghi

Bremner

Slack‐Smith

et al. 2016

Journal of Foot and Ankle Research

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BackgroundThe main purpose of this study was to investigate the presence of an association between intermetatarsal neuroma and foot type, as measured by the Foot Posture Index. The study also examined whether there was a relationship between foot type and the interspace affected with intermetatarsal neuroma, and whether ankle equinus or body mass index had an effect.MethodsIn total, 100 participants were recruited from The University of Western Australia’s Podiatry Clinic, 68 of whom were diagnosed with inter-metatarsal neuroma from 2009 to 2015. There were 32 control participants recruited from 2014 to 2015. The age of subjects was recorded, as were weight and height, which were used to calculate body mass index. The foot posture index and ankle dorsiflexion were measured using standard technique. Independent t-tests and Kruskal-Wallis tests were used to compare differences in foot posture index, body mass index and ankle dorsiflexion between the inter-metatarsal neuroma and control groups. Multivariable logistic regression was also used to model relationships for outcome.ResultsThe 68 intermetatarsal neuroma subjects had a mean age of 52 years (range 20 to 74 years) and comprised of 56 females and 12 males. The 32 control subjects had a mean age of 49 years (range 24 to 67 years) with 26 females and six males. There were no significant differences between the control and the intermetatarsal neuroma groups with respect to the mean foot posture index scores of the left and right foot (p = 0.21 and 0.87, respectively). Additionally no significant differences were detected between the affected intermetatarsal neuroma interspace and foot posture index (p = 0.27 and 0.47, respectively). There was no significant difference in mean body mass index between the intermetatarsal neuroma (26.9 ± 5.7) and control groups (26.5 ± 4.1) (p = 0.72). There was, however, a significant difference in mean ankle dorsiflexion between the intermetatarsal neuroma and control groups (p < 0.001 for both feet). Logistic regression models, adjusted for age, sex, foot posture index and body mass index estimated that the odds of having an intermetatarsal neuroma in the right foot increased by 61% (OR 1.61; 95% CI 1.32–1.96) with each one degree reduction of ankle dorsiflexion, and in the left foot by 43% (OR 1.43; 95% CI 1.22–1.69).ConclusionNo relationships were found between foot posture index and body mass index with intermetatarsal neuroma, or between foot posture index and the interspaces affected. However, a strong association was demonstrated between the presence of intermetatarsal neuroma and a restriction of ankle dorsiflexion.

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Metatarsalgia and Digital Deformities

Richie

Douglas²

2020

Pathomechanics of Common Foot Disorders

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The Idiopathic Cavus Foot–Not So Subtle After All

Cited by 22 publications

References 23 publications

Evaluation of the surgical treatment of subtle cavovarus foot

Evaluation of the surgical treatment of subtle cavovarus foot

The relationship between foot posture index, ankle equinus, body mass index and intermetatarsal neuroma

Metatarsalgia and Digital Deformities

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