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A Preliminary Study of Selective Plantar-Muscle Denervation for Pes Cavus
George J. Garceau; Malcolm A. Brahms
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Orthopaedic Department of the James Whitcomb Riley Memorial Hospital, Indiana University Medical Center, Indianapolis
1956 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1956; 38:553-562 
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Abstract

1. The authors believe that pes cavus is caused by imbalance of the intrinsic muscles of the foot and feel that the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, and quadratus plantae should be particularly studied. The long muscles are seldom involved in the development of this deformity.

2. Cavus deformity of the foot is usually progressive.

3. The preliminary results in the authors' series suggest that selective plantar-muscle denervation may prevent the progressive increase of pes cavus. This prevention will result in improvement in foot balance, performance, stability, and position, and these improvements in turn will stimulate better growth.

4. If the most favorable results are to be obtained, the operation should be performed as soon as possible, for, otherwise, as growth occurs, the bones will be molded into a shape that conforms with the deformed position of the foot.

5. The results to date suggest that the operation is indicated when the deformity is congenital or when it results from either infantile paralysis or congenital club-foot.

6. No ill-effects from the operation have been noted.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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