Presentation
The patient fell and injured his left ankle. Incidental finding.
Patient Data
There is an acute horizontal, non-displaced fracture of the distal left tibial shaft, with an anteroposterior cortical buckling. There is an associated non-displaced oblique fracture of the distal left fibula shaft. There is no extension to the physis and no associated dislocations or subluxations. There is minimal regional soft tissue swelling.
There is incidental pes cavus, with significant forefoot plantar flexion, especially the first metatarsal, the right foot worse than the left.
Case Discussion
Pes cavus is a foot deformity consisting of a cavus (elevation of the longitudinal plantar arch of the foot), plantar flexion of the first ray, forefoot pronation and valgus, hindfoot varus, and forefoot adduction 1. It is usually due to an underlying neuromuscular disorder.
This case demonstrates pes cavus in a patient with known Charcot-Marie-Tooth disease.
There is an increased calcaneal inclination angle, decreased angle of the longitudinal arch, and decreased lateral calcaneal-first metatarsal angle (Hibbs angle).
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