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Adult cavovarus foot
Alastair S E Younger1, Sigvard T Hansen
1Foot and Ankle Program, Providence Health Care, University of British Columbia, Vancouver, Canada.
The Journal of the American Academy of Orthopaedic Surgeons
|September 9, 2005
Summary
Cavovarus foot deformity, often caused by muscle imbalances from hereditary neuropathies, leads to pain and instability. Early tendon rebalancing and surgical correction are crucial to prevent irreversible damage and restore function.
Area of Science:
- Orthopedics
- Neurology
- Biomechanics
Background:
- Cavovarus foot deformity results from muscle imbalances, frequently linked to hereditary motor sensory neuropathies.
- Other etiologies include cerebral palsy, stroke, spinal root injury, talar neck injury, and residual clubfoot.
- The condition involves hindfoot varus and forefoot valgus, leading to lateral foot overload, ankle instability, peroneal tendinitis, and stress fractures.
Purpose of the Study:
- To outline the causes, consequences, and management strategies for cavovarus foot deformity.
- To emphasize the importance of early diagnosis and intervention.
Main Methods:
- Clinical assessment including gait examination and the Coleman block test.
- Evaluation of forefoot and hindfoot alignment to determine surgical needs.
- Review of treatment options including conservative management and surgical interventions.
Main Results:
- Muscle imbalance, particularly from strong peroneus longus and tibialis posterior, drives the deformity.
- Overload of the lateral foot border can lead to degenerative arthritis.
- Conservative measures like orthoses, if prolonged, can exacerbate the imbalance and damage.
Conclusions:
- Early rebalancing of tendons is critical to prevent irreversible deterioration.
- Treatment involves tendon transfers, corrective osteotomies, and fusions to address soft-tissue and bony deformities.
- Proper gait and foot position assessment guides surgical planning for optimal outcomes.