Toes Deformities in Cavovarus: How to Approach Them.

Area of Science:

• Orthopedics
• Foot and Ankle Surgery
• Podiatry

Background:

• Sagittal lesser toe deformities (LTD) are prevalent in cavus foot conditions.
• These deformities often result from muscular imbalances between intrinsic and extrinsic foot muscles.
• Surgical intervention is considered when conservative medical treatments prove ineffective.

Purpose of the Study:

• To provide an updated review on the classification and surgical management of LTD in cavus foot.
• To highlight the role of percutaneous procedures in treating these deformities.
• To focus specifically on sagittal plane deformities of the lesser toes.

Main Methods:

• Review of current literature on cavus foot and lesser toe deformities.
• Analysis of classification systems for sagittal LTD.
• Evaluation of surgical techniques, including joint-sparing procedures, fusions, tendon transfers, and percutaneous methods.
• Consideration of factors influencing surgical choice, such as deformity reducibility, rigidity, and clinical examination findings.

Main Results:

• Joint-sparing procedures are recommended for reducible LTD.
• Lesser toe fusions are indicated for rigid LTD.
• Surgical management may incorporate tendon transfers or percutaneous procedures, tailored to surgeon experience and patient assessment.

Conclusions:

• Effective surgical management of sagittal LTD in cavus foot requires appropriate classification and technique selection.
• Percutaneous procedures offer a minimally invasive option.
• Treatment should be individualized based on deformity characteristics and patient-specific factors.