Cavovarus foot deformity with multiple tarsal coalitions: functional and three-dimensional preoperative assessment

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
Yann Philippe CharlesAlain Diméglio

Abstract

In rare instances, tarsal coalition leads to cavovarus foot deformity, although the pathologic mechanism leading to this deformity is not clear. This article reports a case of a 14-year-old boy presenting a severe cavovarus deformity of the right foot with talocalcaneal and calcaneonavicular coalitions, and a mild cavus deformity of the left foot with a single talocalcaneal coalition. Computed tomography and postoperative histologic analysis demonstrated a synostosis between talus and calcaneus and a fibrous calcaneonavicular coalition with partial ossification. Instrumented gait analysis revealed a limited range of ankle plantar flexion and increased external rotation of the ankle. Associated skeletal malformations including incomplete hemimelia of the forearm and scoliosis raised the possibility of a teratologic condition, but neurologic examination, spinal magnetic resonance imaging, and nerve conduction velocities were normal. The progressive ossification of combined coalitions during growth of the foot may have been one factor leading to this complex foot deformity. The fine-wire electromyogram showed normal tibialis anterior and posterior muscle activity. Small soft tissue tears in the sinus tarsi may have led to a mild r...Continue Reading

References

Apr 1, 1991·Journal of the American Podiatric Medical Association·M S Downey
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May 26, 1998·Journal of Pediatric Orthopedics·T K Comfort, L O Johnson
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Jan 23, 2004·AJR. American Journal of Roentgenology·Julia R Crim, Kristina M Kjeldsberg

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Citations

Jun 16, 2014·Gait & Posture·William SamsonVéronique Feipel
Mar 25, 2009·Journal of Children's Orthopaedics·Vidyadhar V UpasaniScott J Mubarak
Mar 18, 2010·Journal of Children's Orthopaedics·Alison RozanskyScott J Mubarak
May 7, 2008·Foot and Ankle Clinics·Mark C Lee, Daniel J Sucato
Jan 14, 2010·Foot & Ankle International·Maarten KroonMarleen van der Linden

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