Components of the joint-sparing, combined bony and soft tissue correction of the cavovarus foot

Abstract

Combined bony and soft tissue correction of amild foot and flexible rearfoot deformity in cavovarus foot. Drop foot during swing phase and muscular imbalance in the stance phase in cavovarus foot, flexible cavovarus foot, accompanying symptoms such as recurrent calluses and ulcerations, compliance. Pes cavovarus of spastic genesis, mild deformities, fixed bony deformity, lack of compliance, florid inflammation in the foot area, severe peripheral artery disease (PAD), diabetes mellitus. Description of the gradual escalation of joint-sparing bony and soft tissue procedures. Postoperative lower leg cast. In cases of combined bony and soft tissue correction, first 6weeks of nonweight-bearing with lower leg cast, then 6weeks of lower leg walking cast. With adequate bony consolidation, cast removal after atotal of 12weeks. In cases of pure soft-tissue foot correction, 6weeks of lowerleg walking cast. It was shown that only 22.5% of the affected feet (40 preoperative patients with cavovarus foot deformity) had asevere hindfoot equinus due to shortened calf muscles. In astudy with 14patients, it was shown that the tibialis posterior tendon transfer corrects the drop foot component and the excessive medial arch of the feet is significantly reduced by combined soft tissue and bony procedures.