NEW biomechanics

Anterior Cavus
•
Forefoot cavus (apex at Chopart’s joint)
•
Lesser tarsal cavus (apex at lesser tarsal bones)
•
Metatarsal cavus (apex at Lisfranc’s joint)
•
Combined anterior cavus (apex generalized to the lesser tarsal area)

Rearfoot Cavus
•
Calcaneal varus

Lateral
–
Increased talocalcaneal angle
–
Increased calcaneal inclination
–
Decreased talar declination
–
Posterior break in the cyma line
–
“Bullet hole” sinus tarsi



•
AP
–
Decreased talocalcaneal angle
–
Increased metatarsus adductus angle

Deformity in which the
WB portion of the
metatarsals is inverted in
relation to the bi bi-section
of the calcaneus when
STJ is in neutral and
locked

Deformity in which the
WB portion of the
metatarsals is everted in
relation to the bi bi-section
of the calcaneus when
STJ is in neutral and
locked

Inverted position of
posterior aspect of
calcaneous in relation to
the perpendicular of WB
surface when STJ is in
neutral

Type I Pes Cavus: Mild Pes Cavus Deformity

Type II Pes Cavus: Moderate Pes Cavus Deformity

Type III Pes Cavus: Severe Pes Cavus
Deformity:

AP View
↑ Cuboid Abduction Angle (0°-5°)
↑ Kites Angle (15°-25°)
↑ Talar Head Uncovering (<80%)
Underlying Met Add (0-15°)

Abductory Twist
Evans (Flexible, tricorrect)
Fowler
Arthrodesis (Rigid)

Long Leg Calc Axial View (or Lat)
Ant Break in Cyma Line
↑ Kites Angle (15°-25°)
Obliteration of Sinus Tarsi
Valgus Tilt to AJ on AP/Mortise view
Calcaneal Valgus

Everted RCSP
Helbing’s Sign (AT bowing)
Prominent Talar Head

Koutsogiannis (Med Calc Slide)
Arthroeresis

Lateral View
↓ Calc Inclination Angle (19-23°)
Meary’s Angle (0°) ↑ Talar Declination Angle (19-23°) ↑ 1st Met Inclination Angle (19-23°)
Medial Column Fault/Break
Seiberg’s Index
Hibb’s Angle

Equius Silvferskoild Test

TAL if Gastroc-Soleus
Gastroc Recession if Gastroc
Medical Column Fusion (rigid)
Cotton (flexible)
Youngs Tenosuspension (flexible)

- Stays Cavus – RF Driven
- Reduces – FF Driven

ganley splint