Pes Cavus

A 64-year-old female patient with type 2 diabetes diagnosed at the age of 62 years was referred to the outpatient diabetic foot

Type Diabetes FootPes Planus And Pes Cavus
Figure 3.3 Pes planus with bunionette. Dorsal aspect
Foot Care Among Diabetic Patients
Figure 3.4 Pes cavus

clinic for foot care. She had been treated with insulin for the last 4 years. The patient had a history of hypertension. No diabetic complications were mentioned.

On examination, peripheral pulses were bounding. she had severe peripheral neuropathy (no sensation of pain, light touch, temperature, vibration or 5.07 monofilaments) and dry skin. A high plantar arch due to pes cavus was noted, which was more apparent in the standing position. Mild hallux valgus, clawing of the toes, and callus formation over the inner aspect of the first metatarsal heads as well as at the tip of the second toe and the second metatarsal head bilaterally were observed (Figure 3.4). The patient had the callus removed, and the nails cut and she was educated in foot care. suitable shoes and insoles were prescribed and she was advised to attend the foot clinic on a monthly basis for chiropody treatment.

Pes cavus is a deformity not necessarily related to diabetes. indeed, the patient mentioned that her foot shape had been the same before the diagnosis of diabetes and her mother probably had the same deformity.

Normally the inner edge of the mid-foot is raised off the floor forming an arch, which extends between the first metatarsal and the calcaneus. when the arch of the foot is higher than normal (pes cavus) claw toes often develop. in cavus foot the forefoot, and especially the first ray, is drawn downwards and an abnormal distribution of plantar pressure upon standing and walking leads to callus formation under the metatarsal heads. Cavus feet tend to be stiffer than normal; some patients may be prone to ankle strains. Patients should be advised to wear appropriate shoes (extra depth and broad at the toe box) and

Shoes For Pes Cavus
Figure 3.5 Bunionette with claw toes

orthotic, shock-absorbing insoles. Surgery for the correction of the abnormality is rarely recommended.

Keywords: Pes cavus

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