There are many types of surgical procedures that can be performed to correct the cavus foot and restore function and muscle balance. The decision as to which surgery is done depends on the underlying deformity and the pattern of muscle loss and weakness. Our foot and ankle surgeons study each patient individually and develop a specific plan based on the parts of the foot and ankle that are involved. The foot can be divided into four main areas:
- Forefoot (including the toes)
- Midfoot (including the arch)
- Hindfoot (including the heel)
There is always a combination of many procedures that is done all at the same time to correct the various deformities. Occasionally, the surgery has to be staged in two sessions so that the hindfoot and ankle are first corrected followed by the toes. The surgeries can be:
- Tendon transfers to correct muscle weakness
- Bone cuts (called osteotomies) to correct bone deformity
- Soft tissue releases to reposition the arch of the foot
Any and all of the four main areas of the foot can be affected by cavus deformity or CMT. Generally, a combination of a calcaneal (hindfoot) osteotomy, a first metatarsal (forefoot) osteotomy, and a plantar fascia (the thick connective tissue on the bottom of the foot that helps support the arch) release is performed. Occasionally, additional bone cuts (including midfoot osteotomies) and soft tissue procedures (including ankle ligament reconstruction and tendon transfers) are necessary to complete the correction.
As a rule, the surgeons at The Institute for Foot and Ankle Reconstruction at Mercy try to avoid performing a fusion (called an arthrodesis) of the foot if at all possible. In some severe deformities or in cases that involve significant arthritis, certain joints may need to be fused using plates, screws or pins to help decrease pain and correct the deformity.
Unfortunately, this means that some motion in the foot and ankle will be lost permanently. Yet this does not necessarily compromise the patient’s ultimate function. Examples of joint fusion (called arthrodesis) procedures include ankle arthrodesis (which limits up and down motion of the foot) and triple arthrodesis (meaning that three separate joints of the hindfoot are fused together, limiting side to side motion).
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