The Cavovarus foot in hereditary motor and sensory neuropathies

▸Cavovarus foot deformity involves plantar flexion of the first ray relative to the hindfoot (cavus) due to progressive muscular imbalance. A plantar-flexed first ray drives the calcaneus into inversion (varus). ▸The prototypical disorder for understanding the pathomechanics of cavovarus feet is Charcot-Marie-Tooth disorder (or the hereditary motor and sensory neuropathies [HMSNs]). ▸Cavovarus foot deformity comprises a spectrum of anatomical and clinical deformities, and treatment must be individualized to include combinations of soft-tissue releases, osteotomies, tendon transfers, and salvage procedures. ▸Joint-sparing procedures should be performed on skeletally immature patients whenever possible, although arthrodesis has been reported to have good long-term results. ▸To our knowledge, there are no studies on the natural history of untreated cavovarus feet.