Utility of the Coleman block test

The Coleman block test is a key component of the foot and ankle physical examination in children and adults. This review describes the Coleman block test and summarizes its implications in surgical decision making as well as its limitations.

The Coleman block test is a classic technique for evaluating whether the hindfoot deformity in a cavovarus foot is flexible or rigid. It involves placing a wooden block underneath the lateral column of the foot to remove the effect of the plantarflexed first ray of the cavus deformity and assessing whether the hindfoot varus subsequently corrects into valgus. When the hindfoot is flexible, only the cavus requires surgical correction. However, if the hindfoot varus is rigid, additional correction is needed, typically a lateral displacement osteotomy of the posterior calcaneus. More recent modifications to the test include radiographic evaluation of the foot while on the block, and a modification for block placement that is particularly useful in children.

The Coleman block test is a simple clinical test should be performed routinely when assessing cavovarus deformities to help devise the most appropriate surgical plan.