Lateral Displacement Calcaneal Osteotomy Combined With Anterolateral Transfer of the Tibialis Posterior Tendon for Treating Flexible Cavovarus Foot in an Adult Patient: A Case Report.

The cavovarus foot is a spectrum of foot deformity primarily caused by muscular imbalance and characterized by increased pitch, varus of the hindfoot, plantar flexion of the midfoot, and pronation and adduction of the forefoot. Surgery for cavovarus foot commonly involves some combination of procedures, however, no consensus has emerged regarding their choice. We report the case of a 68-year-old male with a flexible cavovarus foot. The patient complained of pain in the subtalar joint and plantar callosities. For this patient, we performed lateral displacement calcaneal osteotomy (LDCO), anterolateral transfer of the tibialis posterior tendon (TPT), and dorsiflexion first metatarsal osteotomy (DFMO). At one year and nine months after surgery, plain radiographs revealed bony union at the osteotomy sites of the calcaneus and first metatarsal. The Japanese Society for Surgery of the Foot hindfoot scale and visual analogue scale improved from 52 points preoperatively to 82 points at the final follow-up and from 3 points to 1 point, respectively. A combination of LDCO, TPT, and DFMO is effective for adult patients with flexible cavovarus foot.