Which foot deformity is associated with pes cavus in sacral S1-S2?

Which foot deformity is associated with pes cavus in sacral S1-S2?

• A. Toe clawing
• B. Flat foot
• C. Hallux valgus
• D. Metatarsus adductus

Answer: (A)

In spina bifida, the pattern of foot deformities reflects the level of the spinal cord involvement. When the lesion is at sacral levels S1–S2, there is a characteristic imbalance between the muscles that control toe flexion and the intrinsic foot muscles. This imbalance tends to produce a rigid high-arched foot, known as pes cavus, and is commonly accompanied by clawing of the toes. The toe clawing comes from disproportionate action of the toe flexors and intrinsic muscles, which pull the toes into a claw-like position while the arch remains elevated. The other deformities listed don’t fit this pattern as well. A flat foot (low arch) points to different muscle/tendon imbalances. Hallux valgus refers to a bunion at the big toe and is not a typical companion of pes cavus. Metatarsus adductus is an inward deviation of the forefoot usually seen in infancy and isn’t the classic pairing with pes cavus in sacral-level involvement. So, the best association with pes cavus in sacral S1–S2 is toe clawing.

In spina bifida, the pattern of foot deformities reflects the level of the spinal cord involvement. When the lesion is at sacral levels S1–S2, there is a characteristic imbalance between the muscles that control toe flexion and the intrinsic foot muscles. This imbalance tends to produce a rigid high-arched foot, known as pes cavus, and is commonly accompanied by clawing of the toes. The toe clawing comes from disproportionate action of the toe flexors and intrinsic muscles, which pull the toes into a claw-like position while the arch remains elevated.

The other deformities listed don’t fit this pattern as well. A flat foot (low arch) points to different muscle/tendon imbalances. Hallux valgus refers to a bunion at the big toe and is not a typical companion of pes cavus. Metatarsus adductus is an inward deviation of the forefoot usually seen in infancy and isn’t the classic pairing with pes cavus in sacral-level involvement.

So, the best association with pes cavus in sacral S1–S2 is toe clawing.