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Custom orthotics with posting of the lateral forefoot and lateral heel
73%
1265/1729
Custom orthotics with posting of the medial forefoot and medial heel
8%
134/1729
Custom orthotics with medial heel posting and lateral forefoot recession
133/1729
Gastrocnemius slide followed by dorsiflexion casting
2%
29/1729
Dorsal first metatarsal osteotomy with calcaneal slide osteotomy
9%
161/1729
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The clinical presentation and photographs demonstrate a patient with bilateral cavovarus feet. The deformity is flexible as evidenced by correction with Coleman block testing. Illustration A provides an example of Coleman block testing. Radiographs demonstrate a high calcaneal pitch, but no arthritic changes. A flexible cavovarus foot can be passively corrected by posting of the lateral forefoot and lateral heel. Surgical interventions should be reserved for fixed deformities and failure of conservative treatment. Sammarco et al reviewed 21 feet with severe symptomatic cavovarus deformity who underwent lateral slide calcaneal osteotomy and dorsal closing wedge osteotomies of the metatarsal(s). The only complications encountered were delayed union and nonunion of the metatarsal osteotomy. Overall, patients did very well with pain reduction, preservation of motion, and enhanced ambulation.
4.3
(23)
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