![]() ![]() Imbalance between relatively weak peroneus brevis and preserved posterior tibialis muscle leads to inversion of calcaneus and adduction of foot. The extensor hallucis muscle which dorsiflexes the toe would then be unable to balance the combined plantarflexing forces of peroneus longus, posterior tibialis, and triceps surae muscles. This forefoot valgus position further drives the hindfoot into inversion. The relatively weak tibialis anterior is overpowered by the strong peroneus longus muscle which plantarflexes the first 1 st ray and pronates the forefoot (making forefoot valgus). Patho-anatomy and PhysiologyĬavus deformity of Charcot Marie Tooth disease is hypothesized to stem from asymmetric foot weakness anterior-laterally due to selective denervation of the tibialis anterior and peroneus brevis muscles of the legs. Severe pes cavus is 30% idiopathic in nature with 70% likely secondary to neurological causes, with most having origins with Charcot Marie Tooth disease (hereditary sensory motor neuropathy). Pes cavus occurs in about 8-15% of the general population.
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