Cavovarus Feet Flashcards
1
Q
What is cavovarus feet?
A
- Foot deformity characterised by elevated logitudinal arch
- caused by fixed plantarflexion of forefoot
- may be seen in paediatric/adult population
2
Q
What is the epidemiology of cavovarus feet?
A
- seen in paeds and adults
- 2/3 rds have neurological disorder
- when bilateral often hereditary
- no genetic predisposition
3
Q
What is the pathophysiology of cavovarus feet?
A
- deformity caused by
- contracted plantar fascia
- Weak tibialis anterior overpowered by Peroneus Longus
4
Q
Name the associated conditions of cavovarus feet?
A
- Charcot Marie Tooth
- Fredreich’s ataxia
- Cerebral Palsy
- Polio
- Spinal cord lesions
5
Q
What are the signs and symptoms of cavovarus feet?
A
Symptoms
- Painful callosus under 1st MT, 5th MT and medial heel due to plantarflexed first ray
signs
-
Coleman block test
- evaluates flexiblity of hindfoot
- by putting block under lateral foot eliminate 1st ray contribution
- a 1st ray that is dorsiflexed can contribute to varus deformity
- Flexible hindfoot can correct to neutral or valgus when block under it
- a rigid hindfoot won’t correct
- Always remove shirt and look for spinal dysraphism
6
Q
Describe the tx for cavovarus feet?
A
Non operative
-
Full length semi rigid insole with lateral heel wedge and repression for 1st MT head
- severe paeds cases and mild adult
Surgery
-
Plantar fascia release, Post tibial transfer, TAL , +/- 1st MT dorsiflexion oseototomy
- for flexible hindfoot- Normal coleman block test
- transfer tib post to dorsum of foot - improve foot drop
- transfer peroneus brevis to longus
- 1st MT dorsal osteotomy and transfer EHL to neck of 1st MT
-
Calcaneal valgus osteotomy- Dwyer lateral closing wedge osteotomy
- for rigid hindfoot
- combinied with PF release+ post tibial transfer+ TAL+ 1st dorsiflexion osteotomy
-
Triple arthrodesis
- for severe rigid deformities
