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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...

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Coalition excision and corrective osteotomies versus coalition excision and arthroereisis in management of pes planovalgus with talo-calcaneal coalition in adolescents: A randomized controlled trial.

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons·2023
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Functional, Radiological, and Biomechanical Outcomes Following Deformity-Driven Multilevel Surgical Correction for

Amr Ashraf Shouman1, Ayman Ebrahim Fathy Hewaidy1, Mohamed Mokhtar Abd-Ella1

  • 1Ain Shams University, Cairo, Egypt.

Foot & Ankle International
|May 19, 2026
PubMed
Summary

This study shows that deformity-driven multilevel surgery significantly improves function and alignment in patients with fixed cavovarus foot deformity. The surgical approach enhances walking speed and plantar pressure distribution, offering a viable treatment option.

Keywords:
calcaneal osteotomycavovarus footgait analysismidfoot osteotomypes cavusplantar pressure

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Area of Science:

  • Orthopedic surgery
  • Biomechanical analysis
  • Foot and ankle reconstruction

Background:

  • Fixed cavovarus foot deformity presents with a plantar-flexed first ray, hindfoot varus, and abnormal plantar loading, leading to pain and gait issues.
  • A deformity-driven surgical approach targets the structural apex and associated components for correction.
  • Limited evidence exists on the biomechanical improvements following this multilevel correction strategy.

Purpose of the Study:

  • To evaluate the functional, radiologic, and biomechanical outcomes of a deformity-driven multilevel surgical correction for fixed cavovarus foot deformity.
  • To assess patient-reported outcomes using the Foot and Ankle Ability Measure Activities of Daily Living (FAAM-ADL) and Foot and Ankle Disability Index (FADI).
  • To analyze changes in radiographic alignment and objective gait and plantar pressure metrics post-surgery.

Main Methods:

  • A prospective case series involving 32 patients (37 feet) with fixed cavovarus deformity underwent a uniform surgical protocol.
  • The protocol included Cole midfoot osteotomy, Dwyer calcaneal osteotomy, and open Achilles tendon lengthening.
  • Patients were followed for at least 18 months, with assessments including FAAM-ADL, FADI, weight-bearing radiographs, and gait/plantar pressure analysis.

Main Results:

  • Significant improvements were observed in FAAM-ADL scores (45.2 to 77.2, P < .001) and FADI scores (P < .001).
  • Radiographic parameters such as Meary angle and calcaneal pitch angle showed significant correction (all P < .001).
  • Gait analysis revealed increased walking speed (1.0 to 1.4 m/s, P < .001) and improved plantar pressure distribution with reduced lateral column loading.

Conclusions:

  • Deformity-driven multilevel surgical correction for fixed cavovarus foot deformity leads to significant improvements in patient function, radiologic alignment, and biomechanics.
  • The apex-targeted multilevel correction strategy is supported for selected patients with rigid midfoot-driven cavovarus deformity.
  • The study highlights the effectiveness of this surgical approach in addressing complex foot deformities.