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Janic Aebi, Monika Horisberger, Arno Frigg
BACKGROUND: Depending on the direction of the subtalar joint, a foot deformity generally tends towards pronation (pes planovalgus) or supination (pes cavovarus). However, the combination of hindfoot varus and flat midfoot/forefoot (pes planovarus) is an exception to this rule. Pes planovarus has so far only been referred to in connection with Müller-Weiss disease and congenital disease. We diagnosed pes planovarus in otherwise healthy patients without these diseases. METHODS: Forty patients with 54 symptomatic feet who were treated between August 2012 and July 2016 were included (mean age, 44...
February 1, 2017: Foot & Ankle International
H d'Astorg, V Rampal, R Seringe, C Glorion, P Wicart
INTRODUCTION: Neurologic pes cavus is a progressive deformity that is difficult to treat during growth. The present study reports results of non-operative management, based on the pathophysiology of the deformity, by untwisting nocturnal splint, preceded in some cases by untwisting walking cast. The objective was to assess efficacy and impact on indications for surgery. METHOD: Twenty-three children (35 feet) were included. All had neurologic cavovarus foot, which was progressive in 24 feet (69%) (Charcot-Marie-Tooth disease)...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Chris A M Aarts, Petra J C Heesterbeek, Perry E M Jaspers, Mark Stegeman, Jan Willem K Louwerens
BACKGROUND: Debate exists regarding the effect of triple fusion on the development of osteoarthritis (OA) of the ankle joint. The midterm outcome after triple arthrodesis and the prevalence of OA following triple arthrodesis are reported in this study. The role of alignment in the development of OA was investigated. METHODS: Seventy five patients (87 feet) were evaluated in 2003 and of these, 48 patients (55 feet) were available for second evaluation in 2008. X-rays of the ankles and feet were made prior to surgery, in 2003 and in 2008, and the level of osteoarthritis (OA) was graded with the Kellgren and Lawrence score...
December 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Andrew G Georgiadis, David A Spiegel, Keith D Baldwin
No abstract text is available yet for this article.
December 22, 2015: JBJS Reviews
Scott VanValkenburg, Raymond Y Hsu, Daniel S Palmer, Brad Blankenhorn, Bryan D Den Hartog, Christopher W DiGiovanni
BACKGROUND: Lateralizing calcaneal osteotomy (LCO) is a frequently used technique to correct hindfoot varus deformity. Tibial nerve palsy following this osteotomy has been described in case reports but the incidence has not been quantified. METHODS: Eighty feet in 72 patients with cavovarus foot deformity were treated over a 6-year span by 2 surgeons at their respective institutions. Variations of the LCO were employed for correction per surgeon choice. A retrospective chart review analyzed osteotomy type, osteotomy location, amount of translation, and addition of a tarsal tunnel release in relation to the presence of any postoperative tibial nerve palsy...
October 2016: Foot & Ankle International
John M Schuberth, Melinda A Bowlby, Jeffrey C Christensen
Posterior tibial tendon transfer has been described to reduce and balance the cavovarus deformity in those patients who receive a total ankle replacement for end-stage arthritis. In this article, we discuss the indications and provide a detailed description of the technique for this powerful procedure. Case examples that demonstrate the utility of the procedure are provided.
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jonathan R M Kaplan, Mark S Myerson
The adult cavovarus foot exists on a spectrum and, therefore, requires a thorough evaluation to determine the extent of the deformity and then choose from a multitude of surgical procedures to achieve correction. Regardless of the severity of the deformity, treatment should include an algorithmic approach to adequately achieve a stable, balanced, and plantigrade foot. To prevent failure, the surgeon should evaluate whether the deformity is flexible or rigid, determine the location of the apex or apices of the deformity, evaluate any muscle imbalances occurring about the foot and ankle, and determine the need for additional procedures...
2016: Instructional Course Lectures
Yong Zhang, Hongwei Liu, Caihong Fu, Yanzhe Ning, Jiajia Zhang, Li Zhou, Zongheng Li, Peng Bai
BACKGROUND: Poststroke cavovarus foot greatly affects patients' activities of daily life and raises the risks of falls and consequent fractures. Acupuncture appears to be safe and effective in promoting motor functions and enhancing the activities of daily life among patients with poststroke cavovarus foot. The current study aims to study the biomechanical effect of acupuncture for poststroke cavovarus foot with objective outcome measurements. METHODS/DESIGN: This is an assessor and analyst-blinded, randomized, controlled pilot study...
March 18, 2016: Trials
R A Fuhrmann, T Pillukat
OBJECTIVE: Realignment and stabilization of the hindfoot by subtalar joint arthrodesis. INDICATIONS: Idiopathic/posttraumatic arthritis, inflammatory arthritis of the subtalar joint with/without hindfoot malalignment. Optional flatfoot/cavovarus foot reconstruction. CONTRAINDICATIONS: Inflammation, vascular disturbances, nicotine abuse. SURGICAL TECHNIQUE: Approach dependent on assessment. Lateral approach: Supine position...
June 2016: Operative Orthopädie und Traumatologie
Kota Watanabe
The orthopedic manifestations in patients with Charcot-Marie-Tooth disease include deformity and dysfunction of the extremities and spine. Conservative treatment is the first choice. Orthosis and rehabilitation can improve function, and are important for the prevention of joint contractures. Foot problems are most commonly observed and require surgical treatment. Foot deformities include pes cavus, cavovarus, claw toes, or drop foot. Single or combined surgeries selected for soft tissues are plantar release, tendon transfer, or Achilles tendon lengthening, and those for bones are osteotomies and joint fusions...
January 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
Nicholas A Beckmann, Sebastian I Wolf, Daniel Heitzmann, Annika Wallroth, Sebastian Müller, Thomas Dreher
BACKGROUND: Charcot-Marie-Tooth disease (CMT), one of the most common hereditary neurologic disorders, often results in debilitating cavovarus foot deformities. The deformities are still not fully understood, and the treatment recommendations are consequently heterogeneous, often including calf muscle or Achilles tendon lengthening. METHODS: We examined 40 patients (80 feet) with CMT and bilateral cavovarus deformities (19 men and 21 women, mean age 33.6 ± 14...
2015: Journal of Foot and Ankle Research
Steven M Raikin, Faith A Schick, Homyar N Karanjia
Peroneal tendon pathology is a commonly reported cause of lateral ankle pain. The causes include cavovarus foot type, overuse, chronic tendinosis, peroneal subluxation or dislocation, acute traumatic split tears, and traumatic rupture. The purpose of the present report is to describe an alternative approach for surgical reconstruction of the peroneal tendons in patients when repair might no longer be effective. The use of a Hunter rod was originally described by Hunter in 1971 for 2-stage reconstruction of tendons in the hand...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
J Hamel
OBJECTIVE: Joint-preserving correction of mild and moderate hindfoot varus deformities by Z-shaped calcaneal osteotomy. INDICATIONS: Mild and moderate subtalar varus deformities in conditions like cavovarus or equinovarus foot deformity, peroneal tendon rupture, malpositioned tarsal fusion, after ankle arthroplasty. CONTRAINDICATIONS: Supramalleolar varus deformities, ankle instability with talar tilting, varus arthritis of the ankle joint, severe subtalar arthritis, and complete loss of peroneal muscle function that should be treated by fusions...
August 2015: Operative Orthopädie und Traumatologie
A Barg, H Hörterer, M Jacxsens, M Wiewiorski, J Paul, V Valderrabano
OBJECTIVE: To correct the underlying inframalleolar varus deformity and to restore physiologic biomechanics of the hindfoot. INDICATIONS: Neurologic, posttraumatic, congenital, and idiopathic cavovarus deformity. In patients with end-stage ankle osteoarthritis with varus heel malposition as additional single-stage procedure complementing total ankle replacement. Severe peroneal tendinopathy with concomitant cavovarus deformity. CONTRAINDICATIONS: General surgical or anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy (e...
August 2015: Operative Orthopädie und Traumatologie
Nivedita U Jerath, John Kamholz, Tiffany Grider, Amy Harper, Andrea Swenson, Michael E Shy
INTRODUCTION: We describe a 6-year-old girl with a T118M PMP22 mutation and heterozygous deletion of PMP22 on chromosome 17 (17p11.2-p12) resulting in a severe sensorimotor polyneuropathy. METHODS: This study is a case report in which the relevant mutations are described. RESULTS: Foot pain, cavovarus feet, tibialis anterior atrophy, absent reflexes, and inability to walk were found when the patient was age 6 years. Nerve conduction studies showed evidence of a sensorimotor polyneuropathy and compressive mononeuropathies of bilateral median nerves at the wrist and ulnar nerves at the elbow...
November 2015: Muscle & Nerve
Steven Erickson, Pooya Hosseinzadeh, Henry J Iwinski, Ryan C Muchow, Vishwas R Talwalkar, Janet L Walker, Todd A Milbrandt
Pedobarography is a common tool for the evaluation of foot deformity. We describe our radiographic and pedobarographic outcomes of surgical treatment of cavovarus foot deformity in children with Charcot-Marie-Tooth disease. Nineteen patients for a total of 30 feet were included. Preoperative and postoperative dynamic pedobarographic measurements were made and analyzed using the five-mask technique. Pedobarographic measures showed statistical significance for increased contact area and decreased peak forces in most mask areas after surgical treatment...
July 2015: Journal of Pediatric Orthopedics. Part B
J Hamel, M Nell
OBJECTIVE: A new method of osteosynthetic stabilization of talonavicular fusion is presented. INDICATIONS: Idiopathic and posttraumatic talonavicular arthritis, talonavicular destruction in rheumatoid arthritis, adult acquired flatfoot deformity, cavovarus deformity, talonavicular degenerative disease in tarsal coalition. CONTRAINDICATION: Major hindfoot deformity or instability, severe osteopenic conditions of tarsal bones. SURGICAL TECHNIQUE: Talonavicular fusion is stabilized with a medioplantar 6...
June 2015: Operative Orthopädie und Traumatologie
James R Jastifer, Michael J Coughlin
UNLABELLED: Calcaneal tuberosity osteotomies are commonly used to treat coronal plane deformities of the hindfoot. Assessing hindfoot alignment can be difficult and there is little evidence to guide the physician when considering the surgical treatment of these deformities. The indications for a calcaneal osteotomy are unclear in the literature because most of the published studies supporting their use are confounded by concurrent procedures such as in adult-acquired flatfoot correction or cavovarus reconstruction...
February 2015: Foot & Ankle Specialist
Joshua N Tennant, Michael Carmont, Phinit Phisitkul
Calcaneal osteotomy is an extra-articular, joint-sparing procedure that is used in the correction of cavovarus and planovalgus foot deformity. Careful indications and contraindications for the procedure, with meticulous surgical technique, should be followed to avoid complications and to achieve optimal outcomes. Multiple options of osteotomies exist, including translational (medializing and lateralizing calcaneal osteotomy, with ability to slide proximally or distally, closing wedge (Dwyer), and rotational type osteotomies (Evans, Z-osteotomy)...
December 2014: Current Reviews in Musculoskeletal Medicine
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