Deformity Correction of Foot and Ankle

Cavovarus Foot Correction

What is Cavovarus Foot?

Cavovarus Foot Correction

To support the entire body’s weight on your two feet, the inner middle portion of each foot (midfoot) is raised off the ground to form an arch. A cavovarus foot deformity is characterized by a higher-than-normal arch of the inner midfoot. This results as the two ends of the foot - the heel and toes - abnormally draw towards the inside of the foot, causing the foot to rest on its outer side. This deformity produces pain in the heel, ball of the foot and outer edge of the foot, instability of gait, frequent ankle sprains, difficulty wearing shoes, callus formation and sometimes stress fractures in the bones on the outer side of the foot.

What are the Causes of Cavovarus Foot?

The cause for cavovarus foot deformity is usually unknown, but it may be associated with neuromuscular conditions such as Charcot-Marie-Tooth disease (progressive muscle weakness), stroke, head injury and poliomyelitis (viral infection that causes paralysis). It may be produced by an imbalance in the strength of the foot muscles, causing muscle contractures (stiffness) or due to bony deformities of the heel bone.

How is a Cavovarus Deformity Corrected?

Cavovarus deformity may be corrected by conservative methods, such as bracing, to help with ankle instability and sprains, and shoe inserts, to raise the lateral border of the foot and accommodate the middle region of the foot. If cavovarus deformity is not adequately controlled by conservative means, your doctor will recommend surgical treatment. Weak muscles and contractures are corrected by a tendon transfer surgery, while bone deformities are corrected by cutting (osteotomy) or fusing bones (arthrodesis) to allow the foot to evenly contact the floor.

Flatfoot Reconstruction

What is Flat Foot Reconstruction?

Foot reconstruction is a surgery performed to correct the structures of the foot and restore the natural functionality of the foot that has been lost due to injury or illness.

Flat foot or pes planus is a condition in which the foot does not have a normal arch when standing.

What are the Indications for Flat Foot Reconstruction?

The primary objectives of flat foot reconstruction are reduction of pain and restoration of function and appearance. This can greatly benefit patients’ medical and aesthetic needs. The surgery to be performed depends on several factors such as the age of the individual, severity and duration of the symptoms.

It is often recommended when conservative treatments fail to resolve the symptoms.

How is a Flat Foot Reconstruction Procedure Performed?

The traditional method of treating flat foot is replaced by a minimally invasive technique (arthroscopy) which can be performed on an outpatient basis.

This procedure is usually performed under general anesthesia. Several tiny incisions are made by your surgeon to insert an arthroscope and miniature surgical instruments into the joint. The camera attached to the arthroscope displays the internal structures on a monitor and your surgeon uses these pictures to evaluate the joint and direct the small surgical instruments either to repair or remove the damaged bone or tendon depending upon the extent of injury.

At the end of the procedure, the surgical incisions are closed by sutures or protected with skin tapes and a soft dressing pad is applied. Depending upon the surgery, your surgeon will place a cast or a splint to prevent movement of the foot until it regains normal functioning capacity.

What are the Advantages of Flatfoot Reconstruction?

Some of the advantages of arthroscopic surgery include:

  • Minimal trauma to the surrounding structures
  • Shorter recovery time with less post-surgical complications
  • Greater range of motion with less post-operative pain
  • Decreased muscle atrophy

What is the Post-Procedural Care for Flat Foot Reconstruction?

Following are the post-surgical guidelines to be followed after reconstruction:

  • Make sure you get adequate rest and avoid using the affected foot for a few weeks.
  • Take medications to help alleviate pain and inflammation as prescribed by your doctor.
  • Apply ice bags over a towel to the affected area for about 15-20 minutes to reduce post-operative pain and swelling.
  • Compression dressings (bandage) are used to support the foot to reduce swelling. Take care not to wrap too tightly which could constrict the blood vessels.
  • Keep the foot elevated at or above the level of your heart to help minimize swelling and discomfort.
  • A wheelchair might be required for a few days in more severe cases.
  • Start rehabilitation (physical therapy) as recommended by your surgeon to improve range of motion.
  • Crutches or a walker may be used to maintain balance or stability while walking. You should begin appropriate exercises to stretch and strengthen the muscles.
  • Cover the splint while showering to keep it clean and dry.
  • Return to sports once the foot has regained normal strength and function with your surgeon's approval.

The outcome of flat foot reconstruction surgery is greatly improved when you, your surgeon, and the physical therapist work together as a team.

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