A claw foot is a deformity of the foot characterized by an excessively high longitudinal arch usually accompanied by dorsal contracture of the toes. The condition is also referred to as cavus foot. The classification of the types of deformities is based on the localized area of the deformity; posterior, anterior, or combined cavus deformity.

The causes of the deformity may be due to anterior horn cell disease, such as poliomyelitis; diastematomyelia or spinal cord tumor; nerve disorders, such as Charcot-Marie Tooth disease and spinal cord dysraphism; muscular diseases, such as muscular dystrophy; long tract and central diseases; idiopathic conditions, such as residual clubfoot; and posttraumatic disorders, such as crush injury.

An excessively high longitudinal arch in the foot characterizes the deformity. There is a decrease in the plantar weight-bearing area with stress in the metatarsal head area. Clawing of the toes may be present, with a reduction in the weight-bearing area. There may also be stiffness of the foot.

The condition is diagnosed by a comprehensive history to determine the onset of the condition and its progression. X-rays are used to determine the type of the deformity.

Treatment may include providing support to the longitudinal arch with a polypropylene ankle foot orthosis. The conservative treatment options may extend from a soft-sole shoe, extra-depth shoes, to an orthotic device. The type of orthotic device ordered will vary according to the severity of the deformity. Care of the skin to prevent breakdown is important when the person is using an orthotic device. The condition may also be managed surgically.

Residuals may include the permanent use of an orthosis. The device may have to be adjusted periodically. Skin care is ongoing to prevent breakdown of the tissue surrounding the device. If surgical correction of the deformity is performed, residuals will depend on the amount of correction, and the response of the deformity to surgical interventions.

• The rating schedule for musculoskeletal was updated on February 7, 2021. Protection still does apply and should be considered with existing evaluations (38 CFR 3.951(a)).

• When multiple foot disabilities are present, but the etiology of the symptoms cannot be separated, assign a single disability evaluation for the predominant symptoms. If the etiology of the symptoms can be delineated, separate disability evaluation may be assigned under multiple DCs for foot disabilities provided that the principles of 38 CFR 4.14 have not been violated.

• None.