Cavovarus Foot Surgery Including a Peroneus Longus Transfer: A 2- to 6-Year Follow-up

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Reconstruction
• Biomechanical Engineering

Background:

• Cavovarus foot deformity presents complex challenges in treatment.
• Surgical correction often involves multiple procedures including tendon transfers and osteotomies.
• Long-term outcomes and patient satisfaction are crucial measures of surgical success.

Purpose of the Study:

• To evaluate patient satisfaction and clinical outcomes following cavovarus foot surgery.
• To assess the effectiveness of peroneus longus to brevis transfer, lateral ligament reconstruction, and osteotomies.
• To determine outcomes at a minimum of 2 years postoperatively.

Main Methods:

• A longitudinal study of 16 patients (17 feet) who underwent cavovarus foot surgery.
• Procedures included peroneus longus to brevis transfer, lateral ligament reconstruction, and first metatarsal osteotomy (with or without calcaneal osteotomy).
• Evaluations included American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scores, visual analog scale (VAS) for pain, and clinical/radiographic assessments.

Main Results:

• Mean AOFAS hindfoot scores improved significantly from 57 to 83 (25-point increase, P < .0001).
• Postoperative VAS pain scores averaged 2 (0-6 range).
• All feet maintained a residual cavovarus deformity on clinical and radiographic examination.

Conclusions:

• Cavovarus foot correction surgery, utilizing tendon transfer and osteotomies, leads to improved patient satisfaction and clinical outcomes.
• The combined surgical approach demonstrates positive intermediate-term results for complex foot deformities.
• Despite residual deformity, the surgical intervention provides significant functional and subjective benefits.