THE PES CAVUS, SCOPING REVIEW

Introduction: Pes cavus is a deformity characterized by cavus (elevation of the longitudinal plantar arch of the foot), plantar flexion of the first radius, forefoot pronation and valgus, rearfoot varus and forefoot adduction. Muscle strength imbalance is the most notable origin of such deformity. Objective: to detail the current information related to pes cavus, concept, manifestations, etiology, epidemiology, presentation, anatomy, pathophysiology, diagnosis, complementary tests, treatment, complications and prognosis. Methodology: a total of 25 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 16 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: pes cavus, cavo-varus, foot deformity, foot muscle strength imbalance. Results: The pathology has a strong underlying association with neurological conditions. It usually occurs in adolescence or early adulthood, although it can occur in any age group. In diabetic patients there is a prevalence of 25%. Mearys line is a line between the talus and the first metatarsal, normally it has a value of 0, in pes cavus it increases, being mild from 5 to 10 degrees and severe above 20. Conclusions: It is important to understand that early identification and intervention are essential to prevent progression from flexible and correctable pes cavus to rigid pes cavus. Therefore, it is essential to know the basis of the pathology, both anatomical, etiological and pathophysiological, as well as its association with other entities or pathologies of the nervous system. In addition, it is necessary to know how to perform an adequate clinical evaluation together with a physical examination and adequate complementary examinations to determine the correct diagnosis and choose the type of treatment to be performed. It is evident that cavovarus foot deformities in adults are frequently approached by means of joint preservation osteotomies and complementary soft tissue procedures, however, currently there are several alternative surgical options available to achieve good results, being the usual first approach to the fixed forefoot deformity and if necessary, to perform a valgus osteotomy. It is recommended that bony correction be performed in conjunction with a soft tissue balancing procedure, in addition to residual toe deformities being restored last. The forms of treatment should be individualized, the choice of the procedure to be used will depend on the deformity and the experience of the surgeon, adapted to the specific clinical picture of each patient. KEY WORDS: pes cavus, metatarsalgia, plantar arch, muscular imbalance.