Dwyer osteotomy in the treatment of pes cavus with varus heel

Abstract

27 patients with 42 Dwyer osteotomies of the calcaneum as a treatment for pes cavus with varus heel, of miscellaneous origin, have been studied. The ages of the patients varied from 7–54 years with a follow-up period of between 25–121 months. The indications for operation included pain and tiredness on weightbearing (88%), instability of the hindfoot and ankle (2.5%), cosmesis (27%) and footwear problems (44%), in those patients who failed to improve with conservative treatment. Assessment included a subjective questionnaire, measurement of the valgus index, and measuring the lateral shift of the os calcis with Cobey's X-ray views. The main complication was recurrence of the heel varus which occurred in those cases of pes cavus which had a well established neurological cause. The study showed 86% excellent and good results and suggested it is a very useful procedure that can be applied in a broad age group of patients and that adequate displacement of the os calcis is essential in neurological pes cavus to prevent recurrence of heel varus.