The cross-sectional areas of the peroneal and anterior muscle compartments at the same level in the upper leg were measured using magnetic resonance imaging in 41 cases of forefoot pes cavus. The pes cavus group included idiopathic cases and pes cavus associated with Charcot-Marie-Tooth disease, Friedreich's ataxia, cerebral palsy, status postpoliomyelitis, nerve trauma, and spinal cord tethering. Thirty-nine of these cases were symptomatic. The results were compared with studies of 11 normal controls. It was found that in the majority of cases of forefoot cavus, the peroneal compartment was enlarged relative to the anterior compartment when compared with the normal controls. Biopsies of the tibialis anterior and peroneus longus muscles in 18 patients with forefoot pes cavus showed that any relative expansion of the peroneus longus was not due to pseudohypertrophy. Overaction of the peroneus longus in comparison to its antagonist the tibialis anterior is proposed as an important factor in the pathogenesis of the majority of symptomatic cases of forefoot pes cavus.
Get full access to this article
View all access options for this article.
References
1.
. AltakoffP.: Zur Analyse des Hohlfusses. Z. Orthop. Chir, 55: 415, 1931.
. BentzonP.G.K.: Pes cavus and musculus peroneus longus. Acta Orthop. Scand., 4: 50, 1938.
4.
. BernatJ.L.OchoaJ.L.: Muscle hypertrophy after partial denervation. A human case. Neurol. Neurosurg. Psychiatry, 41: 719–725, 1978.
5.
. BrewsterA.H.LarsonC.B.: Cavus feet. J. Bone Joint Surg., 22: 361–368, 1940.
6.
. BrockwayA.: Surgical correction of talipes cavus deformities. J. Bone Joint Surg., 22A: 81–91, 1940.
7.
. ChuinardE.G.BaskinM.: Claw foot deformity. J. Bone Joint Surg., 55A(2):351–362, 1973.
8.
. ColeW.N.: The treatment of claw foot. J. Bone Joint Surg., 22: 895, 1940.
9.
. ColemanS.S.ChestnutW. J.;A simple test for flexibility in the cavovarus foot. Clin. Orthop., 123: 60, 1977.
10.
. CoonradR.W.IrwinC.E.BuckerT.WrayJ.B.: The importance of plantar muscles in paralytic varus feet: the results of treatment by neurectomy and myotenotomy. J. Bone Joint Surg., 38A: 563, 1956.
11.
. De VisserM.HoogendijkJ.De VisserB.W.O., And Verbee–ten, B. J.: Calf enlargement in hereditary motor and sensory neuropathy. Muscle Nerve13: 40–46, 1990.
12.
. De VisserM.VerbeetenB.LyppensK.C.H.: Pseudohypertrophy of the calf following 31 radiculopathy. Neuroradiology, 28: 279–280, 1986.
13.
. DicksonF.D.DivelyR.L.: Functional Disorders of the Foot, 3rd Ed.Philadelphia, Lippinccit, 1953.
14.
. DietrichsonP.CoakleyJ.SmithP.E.M.GriffithsR.D.HeliiwellT.R.EdwardsR.H.T.: Conchotome and needle percutaneous biopsy of skeletal muscle. J. Neurol. Neurosurg. Psychiatry, 50: 1461–1467, 1987.
15.
. DrennanJ.C.PriceA.E.: Cavus deformity in hereditary sensory and motor neuropathies: computerized tomographic analysis Proceedings of the Pediatric Orthopaedic Society of North America, Hilton Head, SC, Abstract in Orthop. Trans., 12: 568, 1988.
16.
. DubowitzV.: Muscle Biopsy. A Practical Approach. London, Balliere–Tindall, 1985.
17.
. DuchenneG.B.: Physiologie des Mouvements. Paris, Balliere, 1867.
18.
. DuthieR.B.BentleyG.A. (Eds.): Mercer's Textbook of Orthopaedic Surgery. Baltimore, University Park, 1983, p. 1074.
19.
. DwyerF.C.: The present status of the problem of pes cavus. Clin. Orthop., 106: 254, 1975.
20.
. FickR.: Handbuch der Anatomie und Mechanic der Gelenke. Jena: Fischer, 1911.
21.
. FisherF.R.: On paralytic deformity of the foot. Lancet, 1: 142, 1889.
22.
. FixsenJ.A.: The Foot and Its Disorders. Boston, Blackwell, 1982, pp. 71–73.
23.
. GarceauG.J.BrahmsM.: A preliminary study of selective plantar muscle denervation for pes cavus. J. Bone Joint Surg., 38A (3): 553–561, 1956.
. GordonE.E.: Anatomical and biochemical adaptations of muscle to different exercises. J. A. M. A., 201 (10): 755, 1967.
26.
. HackenbrockM.: Der Hohlfuss. Berlin, Springer, 1926.
27.
. HallgrimsonS.: Pes Cavus, seine Behandlung und einige Bermerkungen ueber seine Aetiologie. Acta Orthop. Scand., 10: 1, 1939.
28.
. HeliiwellT.R.CoakleyJ.SmithP.E.M.EdwardsR.H.T.: The morphology and morphometry of the normal human tibialis anterior muscle. Neuropathol. Appl. Neurobiol., 13: 297–307, 1987.
29.
. HicksJ.H.: The function of the plantar aponeurosis. Arch. Anat, 88: 25, 1964.
30.
. HsuJ.D.: In Disorders of the Foot, Vol 1. JahssM.H. (ed), Philadelphia, W. B. Saunders, 1982, p. 463.
31.
. IkaiM.FukunagaT.: Calculations of muscle strength per unit cross-sectional area of human muscle by means of ultrasonic measurement. Int. Z. Angew. Physiol. Einschliessl. Arbeitsphysiol., 26: 26–32, 1968.
32.
. IkaiM.FukunagaT.: A study on training effect on strength, per unit cross-sectional area of muscle by means of ultrasonic measurement. Int. Z. Angew. Physiol. Einschl. Arbeitsphysiol., 28: 173–180, 1970.
33.
. JahssM.H.: Tarsometatarsal truncated wedge arthrodesis for pes cavus and equinovarus deformity of the forepart of the foot. J. Bone Joint Surg., 62A (5): 713–722, 1980.
34.
. JahssM.H.: Evaluation of the cavus foot for orthopaedic treatment. Clin. Orthop., 181: 52–63, 1983.
35.
. KarlstromG.LonnerholmT.OlerudS.: Cavus deformity of the foot after fracture of the tibial shaft. J. Bone Joint Surg., 57A (7): 893–900, 1975.
36.
. KorczynA.D.KuritzkyA.SandbankU.: Muscle hypertrophy with neuropathy. J. Neurol. Sci., 36: 299–408, 1978.
37.
. LevickG.M.: Action of the intrinsic muscles of the foot. Br. Med. J., 1: 381–382, 1921.
38.
. LittleN.: Claw foot. Med. J. Aust, 495–499, 1938.
. MillsP.: Etiology and treatment of claw foot. J. Bone Joint Surg., 6: 142, 1924.
44.
. O'ConnorB.T.: Some fundamental concepts of pes cavus. Thesis, University of Liverpool, 1959.
45.
. OllerenshawR.: Claw foot. Proc. R. Soc. Med., 20: 1126, 1927.
46.
. ParkerC.A.: Hollow-foot pes cavus. J. A. M. A., 61: 147–159, 19B, 1913.
47.
. PaulosL.ColemanS.S.SamuelsonK.M.: Pes cavovarus. J. Bone Joint Surg., 62A (56): 942–953, 1979.
48.
. PearnJ.HudgsonJ.: Anterior horn cell degeneration and gross calf hypertrophy with adolescent onset. A new spinal muscular atrophy syndrome. Lancet, 1059, 1978.
49.
. PrinceF.P.HikidaR.S.HagermanF.C.: Muscle fiber types in women athletes and nonathletes. Pflugers Arch., 371: 161, 1977.
50.
. RoundJ.M.MatthewsY.JonesD.A.: A quick, simple and reliable histochemical method for ATPase in human muscle preparations. Histochem. J., 12: 707–710, 1980.
51.
. RoyleN.D.: A new conception in the etiology of claw foot and associated talipes equinus. J. Bone Joint Surg., 9: 465, 1927.
52.
. SaltinB.NazarK.CostillD.L.SteinE.JanssonE.EssenB.GollnickP.: The nature of training response; peripheral and central adaptations to one-legged exercise. Acta Physiol. Scand., 96: 229, 1976.
. SaundersJ.T.: Etiology on treatment of claw foot. Arch. Surg., 30 (2): 179–198, 1935.
55.
. ShafferN.M.: Nondeforming clubfoot with remarks on its pathology. Med. Rec, 27: 561, 1885.
56.
. SreterF.A.PinterK.JoleszF., et al.: Fast to slow transformation of fast muscles in response to long-term phasic stimulation. Exp. Neurol., 75: 95–102, 1982.
57.
. SteindlerH.: Treatment of pes cavus. Arch. Surg., 325: 1921.
58.
. SulaimanA.R.KinderD.S.: Vascularized muscle fibers: etiopathogenesis and clinical significance. J. Neurol. Sci., 92: 37–54, 1989.
59.
. SwansonA.B.BrowneH.S.ColemanJ.D.: The cavus foot, concepts of production and treatment by metatarsal osteotomy. J. Bone Joint Surg., 48A (5) 1019, 1966.
