What is the role of tendon transfer in the cavus foot?

Cavovarus deformity results from an imbalance of the foot's extrinsic musculature. Conditions leading to weakness of an isolated muscle result from nerve injury or sequelae of a compartment syndrome. When weakness of a muscle group presents, an underlying neurologic disorder must be suspected. Patients with hereditary sensory motor neuropathy present with a progressive pattern of imbalance and deformity. The deformity starts out flexible but becomes rigid over time. Rebalance muscle pull to realign the foot and ankle is important. Osteotomies and arthrodesis to realign the hindfoot will not maintain alignment as long as the agonist-antagonist pattern is not re-established.