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Nonneuro-muscular Flexible Pes Cavus
Subtle lower extremity malalignment, in the form of nonneuromuscular flexible pes cavus (NFPC), is common. The medial arch of the foot is created by the presence of static and dynamic supports. Without the structural integrity of the plantar fascia; the talonavicular capsule; and the calcaneonavicular (spring), deltoid, talocalcaneal interosseous, and long and short plantar ligaments, a pes planus (flatfoot) or collapse of the medial arch would result. Therefore, by definition, a cavus foot is a relatively rigid structure, and the term flexible must be used with caution. Flexibility of a pes cavus foot refers to the ability to correct the foot structures to a neutral position. In particular, this term refers to the flexibility of the plantarflexed first ray, the tightness of the plantar fascia, the contractures of the gastrocnemius muscle, and the ability to rotate the subtalar joint complex past a neutral position to an everted position.