When A Patient Presents With Collapsing Pes Planovalgus

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Author(s): 
Ryan H. Fitzgerald, DPM, AACFAS

   Additionally, I performed a medial displacement calcaneal osteotomy (MDCO) to medially direct the forces through the rearfoot (see photos 6-8).

   The patient wore a Jones compression dressing postoperatively and transitioned to a short leg cast at the first office visit. The patient then wore a cast for approximately eight weeks and subsequently transitioned to a removable cam-walker (RCW). The patient was able to bear weight in the RCW. At this point, he went to physical therapy to initiate passive range of motion exercises. At 12 weeks, he returned to normal shoe gear with further physical therapy to strengthen the medial arch suspension.

In Conclusion

The management of collapsing pes planovalgus deformities is complex and can pose a challenge to the foot and ankle surgeon. This condition is a multiplanar deformity. When attempting surgical reconstruction, one must determine planal dominance and address each component of the deformity.

   Dr. Fitzgerald is in private practice at Hess Orthopaedics and Sports Medicine in Harrisonburg, Va. He is an Associate of the American College of Foot and Ankle Surgeons.

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marvene blackmoresays: February 5, 2011 at 8:49 pm

Addressing the actual problems for the patient's benefit is always excellent practice. Strongly agree that calcaneal osteotomy be used rather than destruction of healthy bone, tissue, and function methods such as subtalar and metatarsal fusions.

Pre-planning is also essential. For example, why put a fusion rod in the subtalar ever, and especially when a later ankle arthroplasty is probable?

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