Cavovarus Foot Correction (high arches)

Correction of a foot that has high arches and a heel that turns in can be due to a variety of causes such as spinal problems, neurological diseases or it can arise by itself.

These feet are complex and are amongst the most challenging surgeries. There is no set recipe for these patients and each case is different. Often these cases involve multiple procedures at the same time involving soft tissue and bony corrections.

Possible procedures for this type of foot include:

  • Achilles tendon lengthening

  • Tendon transfer of tibialis posterior

  • Release of plantar fascia

  • Peroneal tendon transfer

  • Calcaneal osteotomy

  • Dorsiflexion osteotomy of first metatarsal

  • Big toe fusion

  • Extensor tenotomies

Figure 1: patient who has undergone correction of a cavovarus (high arched) foot

Figure 2: typical high arch and clawed toes seen in cavovarus feet

Post-operative plan:

  • Surgery is typically 1-2 stay

  • Local anaesthetic is administered to help with pain

  • 0-2 weeks: elevation at home, plaster cast

  • 2-6 weeks: Non weight bearing in a lightweight cast or CAMboot

  • 6-10 weeks onwards: walk in moon boot

  • >12 weeks: may need a night-time thermoplastic splint

Download post-operative care guide

Risks of surgery

  • Swelling, stiffness

  • Infection and wound breakdown

  • Blood clots

  • Scar sensitivity

  • Ongoing pain

  • Recurrence of deformity

  • Progression to arthritis of the foot or ankle joints