(ii) The cavo-varus foot

Cavo-varus foot deformity has many causes but the final common pathway is an imbalance of the muscles acting on the foot. The commonest cause of bilateral deformity is Charcot Marie Tooth disease. Unilateral deformity may arise from spinal pathology. Symptoms range from ankle instability and fatigue fractures to abnormal gait and the effects of joint overload.As well a clinical assessment, patients may require neuro-physiological investigation, and foot and spinal imaging. Treatment ranges from footwear modifications and orthoses to surgical treatment which may include combination of soft tissue releases, tendon transfers or a variety of osteotomies. Severe or recurrent deformities may require joint arthrodesis.