대한족부족관절학회지 (Journal of Korean Foot and Ankle Society)

  • 제20권2호
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  • Pages.55-61
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  • 2016
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  • 1738-3757(pISSN)
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  • 2288-8551(eISSN)
대한족부족관절학회 (Korean Foot & Ankle Society)
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요족의 진단과 치료

Diagnosis and Treatment of Cavus Foot

  • 서재완 (단국대학교병원 정형외과) ;
  • 최우진 (연세대학교 의과대학 정형외과학교실) ;
  • 이진우 (연세대학교 의과대학 정형외과학교실)
  • Suh, Jae Wan (Department of Orthopaedic Surgery, Dankook University Hospital) ;
  • Choi, Woo Jin (Department of Orthopaedic Surgery, Yonsei University College of Medicine) ;
  • Lee, Jin Woo (Department of Orthopaedic Surgery, Yonsei University College of Medicine)
  • 투고 : 2016.05.11
  • 심사 : 2016.05.23
  • 발행 : 2016.06.15
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초록

The cavus foot is a deformity characterized by an elevated medial longitudinal arch and a hindfoot varus with plantarflexed 1st ray. The etiology of cavus foot is usually related to neuromuscular disease or idiopathic cause. Thorough clinical and radiographic evaluation is required for differentiating etiology of the cavus. Most cases of cavus foot are stable and slowly progressive deformities which can initially be managed with conservative treatment including orthoses and physical therapies. Determining whether the deformity is flexible or rigid, the apex of the deformity and any muscle imbalances in foot and ankle is important for achievement of an adequately balanced plantigrade foot. Treatment should include systematic preoperative planning for selection of appropriate procedures for maintaining a functional and flexible foot with combinations of soft-tissue release, osteotomy, tendon transfer, and arthrodesis.

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참고문헌

  1. Faldini C, Traina F, Nanni M, Mazzotti A, Calamelli C, Fabbri D, et al. Surgical treatment of cavus foot in Charcot-Marie-Tooth disease: a review of twenty-four cases: AAOS exhibit selection. J Bone Joint Surg Am. 2015;97:e30. https://doi.org/10.2106/JBJS.N.00794
  2. Fabian G, Krause GPG. Pes cavus. In: Coughlin MJ, Saltzman CL, Anderson RB, editors. Mann's surgery of the foot and ankle. 9th ed. Philadelphia: Saunders/Elsevier; 2014. p.1361-82.
  3. Nogueira MP, Farcetta F, Zuccon A. Cavus foot. Foot Ankle Clin. 2015;20:645-56. https://doi.org/10.1016/j.fcl.2015.07.007
  4. Ortiz C, Wagner E, Keller A. Cavovarus foot reconstruction. Foot Ankle Clin. 2009;14:471-87. https://doi.org/10.1016/j.fcl.2009.03.006
  5. Brewerton DA, Sandifer PH, Sweetnam DR. "Idiopathic" pes cavus: an investigation into its aetiology. Br Med J. 1963;2:659-61. https://doi.org/10.1136/bmj.2.5358.659
  6. Holmes JR, Hansen ST Jr. Foot and ankle manifestations of Charcot-Marie-Tooth disease. Foot Ankle. 1993;14:476-86. https://doi.org/10.1177/107110079301400809
  7. Nagai MK, Chan G, Guille JT, Kumar SJ, Scavina M, Mackenzie WG. Prevalence of Charcot-Marie-Tooth disease in patients who have bilateral cavovarus feet. J Pediatr Orthop. 2006;26:438-43. https://doi.org/10.1097/01.bpo.0000226278.16449.c4
  8. Marks RM. Midfoot and forefoot issues cavovarus foot: assessment and treatment issues. Foot Ankle Clin. 2008;13:229-41. https://doi.org/10.1016/j.fcl.2008.02.007
  9. Deben SE, Pomeroy GC. Subtle cavus foot: diagnosis and management. J Am Acad Orthop Surg. 2014;22:512-20. https://doi.org/10.5435/JAAOS-22-08-512
  10. Manoli A 2nd, Graham B. The subtle cavus foot, "the underpronator". Foot Ankle Int. 2005;26:256-63. https://doi.org/10.1177/107110070502600313
  11. Manoli A 2nd, Smith DG, Hansen ST Jr. Scarred muscle excision for the treatment of established ischemic contracture of the lower extremity. Clin Orthop Relat Res. 1993;(292):309-14.
  12. Abbasian A, Pomeroy G. The idiopathic cavus foot-not so subtle after all. Foot Ankle Clin. 2013;18:629-42. https://doi.org/10.1016/j.fcl.2013.08.004
  13. Mann RA, Missirian J. Pathophysiology of Charcot-Marie-Tooth disease. Clin Orthop Relat Res. 1988;(234):221-8.
  14. Mosca VS. The cavus foot. J Pediatr Orthop. 2001;21:423-4.
  15. Aminian A, Sangeorzan BJ. The anatomy of cavus foot deformity. Foot Ankle Clin. 2008;13:191-8. https://doi.org/10.1016/j.fcl.2008.01.004
  16. Martyn CN, Hughes RA. Epidemiology of peripheral neuropathy. J Neurol Neurosurg Psychiatry. 1997;62:310-8. https://doi.org/10.1136/jnnp.62.4.310
  17. Guyton GP, Mann RA. The pathogenesis and surgical management of foot deformity in Charcot-Marie-Tooth disease. Foot Ankle Clin. 2000;5:317-26.
  18. VanderHave KL, Hensinger RN, King BW. Flexible cavovarus foot in children and adolescents. Foot Ankle Clin. 2013;18:715-26. https://doi.org/10.1016/j.fcl.2013.08.006
  19. Lee MC, Sucato DJ. Pediatric issues with cavovarus foot deformities. Foot Ankle Clin. 2008;13:199-219. https://doi.org/10.1016/j.fcl.2008.01.002
  20. Tynan MC, Klenerman L, Helliwell TR, Edwards RH, Hayward M. Investigation of muscle imbalance in the leg in symptomatic forefoot pes cavus: a multidisciplinary study. Foot Ankle. 1992;13:489-501. https://doi.org/10.1177/107110079201300901
  21. Wicart P. Cavus foot, from neonates to adolescents. Orthop Traumatol Surg Res. 2012;98:813-28. https://doi.org/10.1016/j.otsr.2012.09.003
  22. Barenfeld PA, Weseley MS, Shea JM. The congenital cavus foot. Clin Orthop Relat Res. 1971;79:119-26. https://doi.org/10.1097/00003086-197109000-00018
  23. Perera A, Guha A. Clinical and radiographic evaluation of the cavus foot: surgical implications. Foot Ankle Clin. 2013;18:619-28. https://doi.org/10.1016/j.fcl.2013.08.010
  24. Saltzman CL, el-Khoury GY. The hindfoot alignment view. Foot Ankle Int. 1995;16:572-6. https://doi.org/10.1177/107110079501600911
  25. Alexander IJ, Johnson KA. Assessment and management of pes cavus in Charcot-Marie-Tooth disease. Clin Orthop Relat Res. 1989;(246):273-81.
  26. Dwyer FC. The present status of the problem of pes cavus. Clin Orthop Relat Res. 1975;(106):254-75.
  27. Georgiadis AG, Spiegel DA, Baldwin KD. The cavovarus foot in hereditary motor and sensory neuropathies. JBJS Reviews 2015;3:e5.
  28. Mubarak SJ, Van Valin SE. Osteotomies of the foot for cavus deformities in children. J Pediatr Orthop. 2009;29:294-9. https://doi.org/10.1097/BPO.0b013e31819aad20
  29. Aktas S, Sussman MD. The radiological analysis of pes cavus deformity in Charcot Marie Tooth disease. J Pediatr Orthop B. 2000;9:137-40. https://doi.org/10.1097/01202412-200004000-00012
  30. Bradley GW, Coleman SS. Treatment of the calcaneocavus foot deformity. J Bone Joint Surg Am. 1981;63:1159-66. https://doi.org/10.2106/00004623-198163070-00014
  31. Krause FG, Wing KJ, Younger AS. Neuromuscular issues in cavovarus foot. Foot Ankle Clin. 2008;13:243-58. https://doi.org/10.1016/j.fcl.2008.02.003
  32. Schwend RM, Drennan JC. Cavus foot deformity in children. J Am Acad Orthop Surg. 2003;11:201-11. https://doi.org/10.5435/00124635-200305000-00007
  33. Jahss MH. Tarsometatarsal truncated-wedge arthrodesis for pes cavus and equinovarus deformity of the fore part of the foot. J Bone Joint Surg Am. 1980;62:713-22. https://doi.org/10.2106/00004623-198062050-00004
  34. Cole WH. The treatment of claw-foot. J Bone Joint Surg Am. 1940;22:895-908.
  35. Japas LM. Surgical treatment of pes cavus by tarsal V-osteotomy. Preliminary report. J Bone Joint Surg Am 1968;50:927-44.
  36. Dwyer FC. Osteotomy of the calcaneum for pes cavus. J Bone Joint Surg Br. 1959;41:80-6.
  37. Knupp M, Horisberger M, Hintermann B. A new z-shaped calcaneal osteotomy for 3-plane correction of severe varus deformity of the hindfoot. Tech Foot Ankle Surg. 2008;7:90-5. https://doi.org/10.1097/BTF.0b013e318
  38. Koutsogiannis E. Treatment of mobile flat foot by displacement osteotomy of the calcaneus. J Bone Joint Surg Br. 1971;53:96-100.
  39. Krause F, Windolf M, Schwieger K, Weber M. Ankle joint pressure in pes cavovarus. J Bone Joint Surg Br. 2007;89:1660-5.
  40. Bariteau JT, Blankenhorn BD, Tofte JN, DiGiovanni CW. What is the role and limit of calcaneal osteotomy in the cavovarus foot? Foot Ankle Clin. 2013;18:697-714. https://doi.org/10.1016/j.fcl.2013.08.001
  41. Kaplan JR, Myerson MS. The failed cavovarus foot: what went wrong and why? Instr Course Lect. 2016;65:331-44.
  42. Henderson CP, Parks BG, Guyton GP. Lateral and medial plantar pressures after split versus whole anterior tibialis tendon transfer. Foot Ankle Int. 2008;29:1038-41. https://doi.org/10.3113/FAI.2008.1038
  43. Ward CM, Dolan LA, Bennett DL, Morcuende JA, Cooper RR. Long-term results of reconstruction for treatment of a flexible cavovarus foot in Charcot-Marie-Tooth disease. J Bone Joint Surg Am. 2008;90:2631-42. https://doi.org/10.2106/JBJS.G.01356