A Case of Cavus: Tackling Post Operative Recurrence

Abstract

Pes cavovarus deformities of the foot and ankle pose significant challenges for patients and clinicians, often leading to debilitating symptoms and sequelae. This case study presents a 67-year-old female patient who underwent multiple surgical corrections for recurrent cavus foot deformity. The initial surgery involved Tendo-Achilles Lengthening, Dwyer Calcaneal Osteotomy, and Total Ankle Arthroplasty. However, over time, the deformity migrated to the forefoot and midfoot, necessitating further interventions, including dorsiflexory wedge osteotomy and IPJ fusion. Despite these efforts, the cavus deformity recurred in the rearfoot in 2022, leading to a comprehensive surgical approach. The procedures included soft tissue and osseous corrections, such as posterior tibial tendon lengthening, deltoid release, hardware removal, lateral calcaneal sliding osteotomy, and polyethylene replacement of the ankle arthroplasty. The patient experienced pain relief and improved function following this intervention. The study highlights the challenges associated with managing cavovarus deformities and the importance of a systematic approach to address both soft tissue contractures and osseous abnormalities. Furthermore, it underscores the potential for recurrence in such cases, necessitating vigilant postoperative monitoring and adaptable treatment strategies. While the patient achieved positive outcomes twelve months postoperatively, this case emphasizes the need for careful pre-operative planning and consideration of various surgical techniques to effectively manage pes cavovarus deformities and their recurrent nature.