title: Surgical management and treatment algorithm for the subtle cavovarus foot.
abstract: BACKGROUND
  Subtle cavovarus foot is a condition that can lead to significant foot pain and disability. We review the results of our treatment algorithm at medium-term followup.
  
  
  METHODS
  Thirty-five consecutive patients with lateral based symptoms due to an underlying congenital subtle cavovarus foot type were surgically corrected. Various procedures were utilized, including some combination of the following: lateral displacement calcaneus osteotomy, peroneus longus to brevis transfer, dorsiflexion first metatarsal osteotomy, and Achilles tendon lengthening. Twenty-three patients, with 29 feet, returned for followup examination. The mean patient age at the time of surgery was 43.4 years, and the mean followup to date was 4.4 years.
  
  
  RESULTS
  The mean AOFAS ankle hindfoot score preoperatively was 45, and postoperatively was 90. Radiographically, the medial cuneiform to floor height changed from 3.5 cm preoperatively to 3.0 cm postoperatively. The talo-first metatarsal angle improved 7.5 degrees postoperatively. There were no nonunions. No patients to date have gone on to fusions or revisions. Ten feet (34%) required hardware removal. All patients had resolution of their symptoms following hardware removal.
  
  
  CONCLUSIONS
  The surgical management for the subtle cavovarus foot based on the proposed treatment algorithm provided symptomatic relief, longstanding correction, and high patient satisfaction.
authors.affiliation: Orthopaedic Associates of Kalamazoo, 3810 Centre Avenue, Portage, MI 49024, USA. mmaskill2@yahoo.com
authors.forename: Michael P
authors.initials: MP
authors.lastname: Maskill
authors.forename: John D
authors.initials: JD
authors.lastname: Maskill
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Pomeroy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D005260:Female; D005500:Follow-Up Studies; D005530:Foot Deformities / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011859:Radiography