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Innovations in the Cavus Foot Deformity, An Issue of Foot and Ankle Clinics, E-Book

Innovations in the Cavus Foot Deformity, An Issue of Foot and Ankle Clinics, E-Book

Anish R. Kadakia

(2013)

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Book Details

Abstract

This issue of Foot and Ankle Clinics will focus on all aspects of surgical treatment of Cavus foot deformities, from an orthopedic standpoint. It will cover related surgical techniques to revise problems in the forefoot, arch, and ankle (all are affected by the disease). It will also address specific instances, such as pediatric patients, and cases where total ankle arthroplasty are required.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Innovations in the Cavus Foot Deformity\r i
Copyright\r ii
Contributors iii
Contents vii
Foot And Ankle Clinics\r x
Erratum xi
Preface\r xiii
Clinical and Radiographic Evaluation of the Cavus Foot 619
Key points 619
Plain film radiology 619
Diagnosis of Pes Cavus 619
Ankle Radiographs 620
Foot Radiographs 622
Hindfoot Alignment Radiographs 624
Degenerative joint disease 625
Peroneal tendon evaluation 626
Summary 628
References 628
The Idiopathic Cavus Foot–Not So Subtle After All 629
Key points 629
Introduction 629
Pathoanatomy 630
Symptomatology 631
Forefoot 631
Midfoot 631
Hindfoot 633
Ankle 633
Lower Limb 633
Clinical assessment 633
Inspection 634
Examination 635
Radiology and special investigations 636
Management 637
Nonsurgical 637
Nonsurgical treatment of the associated condition 638
Nonsurgical treatment of the underlying cavus 638
Surgery 638
Summary 641
References 641
Treatment of Ankle Instability with an Associated Cavus Deformity 643
Key points 643
Introduction 643
Pes cavus and cavovarus 644
Foot mechanics in relation to ankle instability 644
The “subtle cavus” foot 645
Radiologic correlation 645
Neuromuscular issues in chronic instability 647
Assessment of the cavus foot 648
Nonoperative treatment 650
Operative treatment 651
Dorsiflexion First-Ray Osteotomy 651
Heel Varus 651
Lateral Ligament Reconstruction 652
Gastrocnemius Lengthening 652
Associated pathology 652
Consequences of chronic instability 653
Summary 655
References 655
Joint-Sparing Correction for Idiopathic Cavus Foot 659
Key points 659
Introduction 659
Surgical options 661
Lateral Sliding Calcaneal Osteotomy 661
First Metatarsal Base Dorsiflexion Osteotomy 662
Midfoot Dorsal Wedge Osteotomy 663
Soft Tissue Procedures 663
Clinical and radiographic outcome correlation 664
Discussion 665
References 670
Joint Sparing Correction of Cavovarus Feet in Charcot-Marie-Tooth Disease 673
Key points 673
Introduction 673
Motor imbalance in Charcot-Marie-Tooth disease 675
Patient evaluation as a guide to surgical management 676
Joint sparing surgical options 676
Hindfoot surgery 677
Hindfoot Alignment 678
The Coleman Block Test 678
Calcaneal Osteotomies 679
Forefoot and Midfoot Osteotomies 679
Dorsiflexion osteotomy of the first metatarsal 680
Dorsiflexion midfoot osteotomies 680
Soft-tissue releases 681
Plantar Fascia Release 681
Tendoachilles Lengthening 682
Tendon transfers 683
Peroneus Longus to Brevis Transfer 683
Tibialis Posterior Tendon Transfer 683
Tibialis Anterior Tendon Transfer 683
Toe deformities 684
Jones Procedure 684
Flexor to Extensor Tendon Transfer 684
Extensor Tendon Transfers 684
The surgical plan 684
Outcomes of surgery 685
Summary 686
References 686
What is the Role of Tendon Transfer in the Cavus Foot? 689
Key points 689
Pathomechanical considerations 689
Clinical evaluation 690
Surgical treatment 690
The principles of tendon transfer 691
Tendon transfers 692
Peroneus Longus-to-Brevis Tendon Transfer 692
Posterior Tibial Tendon Transfer 693
Anterior Tibial Tendon Transfer 694
Extensor Hallucis Longus and Extensor Digitorum Longus Transfers 694
Summary 694
References 694
What is the Role and Limit of Calcaneal Osteotomy in the Cavovarus Foot? 697
Key points 697
Introduction 697
Types of cavus feet 699
Subtle (Mild) 699
Severe 699
Common calcaneal osteotomies 699
Calcaneal osteotomy indications 702
Biomechanics of calcaneal osteotomy 705
Clinical results of calcaneal osteotomies 706
Limitations of the calcaneal osteotomy 707
The authors’ preferred techniques 708
Lateralizing Calcaneal Osteotomy 708
Triplanar Z-Osteotomy 709
Summary 712
References 712
Flexible Cavovarus Foot in Children and Adolescents 715
Key points 715
Anatomy/Background 715
Cause 716
Peripheral Nerve 716
Central Nervous System 717
Spinal Abnormalities 718
Other Causes 718
Clinical presentation 718
Physical examination 718
Imaging 719
Radiographs 719
Other Diagnostic Evaluation 721
Management of the flexible cavus foot 721
Nonoperative management 721
Surgical management of flexible cavovarus foot 722
Toe Deformities 722
Soft Tissue Procedures 722
Tendon Transfers 723
Forefoot Osteotomies 723
Midfoot Osteotomies 723
Summary 724
References 725
Management of the Rigid Cavus Foot in Children and Adolescents 727
Key points 727
Metatarsal osteotomies 728
Proximal midtarsal and midfoot biplanar osteotomies 729
Medial-lateral midfoot biplanar osteotomies 730
Multiplanar correction with external fixation 732
Multiplanar osteotomies 732
Akron dome midfoot osteotomy 733
Discussion 735
Summary 738
References 738
The Indications and Technique for Surgical Correction of Pes Cavus with External Fixation 743
Key points 743
Introduction 743
Treatment methods 744
Indications for external fixation 744
Gradual correction methods 745
Algorithmic approach for cavovarus correction with external fixation 746
Distraction osteotomies 747
U-Osteotomy 747
V-Osteotomy 748
Y-Osteotomy 748
External fixator application 749
Complications 751
Summary 752
References 752
Arthrodesis for the Cavus Foot 755
Key points 755
Introduction 755
Clinical evaluation 756
Deformity correction 757
Midfoot Arthrodesis 758
Triple Arthrodesis 761
Summary 766
References 766
Index 769