Abstract：
UNASSIGNED: The cavovarus foot is a complex 3-dimensional deformity. Although a multitude of techniques are described for its surgical management, few of these are evidence based or guided by classification systems. Surgical management involves realignment of the hindfoot and soft tissue balancing, followed by forefoot balancing. Our aim was to analyze the pattern of residual forefoot deformities once the hindfoot is corrected, to guide forefoot correction.
UNASSIGNED: We included 20 cavovarus feet from 16 adult patients with Charcot-Marie-Tooth who underwent weightbearing CT (mean age 43.4 years, range: 22-78 years, 14 males). Patients included had flexible deformities, with no previous surgery. Using specialized software (Bonelogic 2.1, Disior) a 3-dimensional, virtual model was created. Using morphologic data captured from normal feet in patients without pathology as a guide, the talonavicular joint of the cavovarus foot was digitally reduced to a \"normal\" position to simulate the correction that would be achieved during surgical correction. Models of the corrected position were exported and geometrically analyzed using Blender 3.64 to identify anatomical trends.
UNASSIGNED: We identified 4 types of cavovarus forefoot morphotypes. Type 0 was defined as a balanced forefoot (2 cases, 10%). Type 1 was defined as a forefoot where the first metatarsal was relatively plantarflexed to the rest of the foot, with no significant residual adduction after talonavicular joint correction (12 cases, 60%). Type 2 was defined as a forefoot where the second and first metatarsals were progressively plantarflexed, with no significant adduction (4 cases, 20%). Type 3 was defined as a forefoot where the metatarsals were adducted after talonavicular derotation (2 cases, 10%).
UNASSIGNED: In this relatively small cohort, we identified 4 forefoot morphotypes in cavovarus feet that might help surgeons to recognize and anticipate the residual forefoot deformities after hindfoot correction. Different treatment strategies may be required for different morphotypes to achieve balanced correction.
UNASSIGNED: Level IV, retrospective case series.
UNASSIGNED: We included 20 cavovarus feet from 16 adult patients with Charcot-Marie-Tooth who underwent weightbearing CT (mean age 43.4 years, range: 22-78 years, 14 males). Patients included had flexible deformities, with no previous surgery. Using specialized software (Bonelogic 2.1, Disior) a 3-dimensional, virtual model was created. Using morphologic data captured from normal feet in patients without pathology as a guide, the talonavicular joint of the cavovarus foot was digitally reduced to a \"normal\" position to simulate the correction that would be achieved during surgical correction. Models of the corrected position were exported and geometrically analyzed using Blender 3.64 to identify anatomical trends.
UNASSIGNED: We identified 4 types of cavovarus forefoot morphotypes. Type 0 was defined as a balanced forefoot (2 cases, 10%). Type 1 was defined as a forefoot where the first metatarsal was relatively plantarflexed to the rest of the foot, with no significant residual adduction after talonavicular joint correction (12 cases, 60%). Type 2 was defined as a forefoot where the second and first metatarsals were progressively plantarflexed, with no significant adduction (4 cases, 20%). Type 3 was defined as a forefoot where the metatarsals were adducted after talonavicular derotation (2 cases, 10%).
UNASSIGNED: In this relatively small cohort, we identified 4 forefoot morphotypes in cavovarus feet that might help surgeons to recognize and anticipate the residual forefoot deformities after hindfoot correction. Different treatment strategies may be required for different morphotypes to achieve balanced correction.
UNASSIGNED: Level IV, retrospective case series.
摘要：
■cavovarus足是一种复杂的3维畸形。尽管描述了用于其手术管理的多种技术，其中很少是基于证据或由分类系统指导的。手术治疗包括后足的重新对准和软组织平衡，其次是前脚平衡。我们的目的是分析后足矫正后残余前足畸形的模式，指导前脚矫正。
■我们纳入了16名接受过负重CT的Charcot-Marie-Tooth成年患者的20只脚（平均年龄43.4岁，范围：22-78岁，14名男性）。患者包括有柔性畸形，以前没有手术。使用专门的软件(Bonelogic2.1，Disior)三维，虚拟模型已创建。使用从没有病理学的患者的正常脚捕获的形态学数据作为指导，cavervarus足的距骨关节被数字化地缩小到“正常”位置，以模拟手术矫正过程中的矫正。输出校正位置的模型，并使用Blender3.64进行几何分析，以确定解剖趋势。
■我们确定了4种类型的cavovarus前足形态类型。0型被定义为平衡的前足(2例，10%)。1型被定义为前足，其中第一meta骨相对于脚的其余部分相对于足底弯曲，距骨关节矫正后无明显残余内收（12例，60%）。2型被定义为前足，其中第二和第一meta骨逐渐屈伸，无明显内收(4例，20%）。类型3被定义为前足，其中在距骨脱位后，meta骨被内收（2例，10%)。
■在这个相对较小的群体中，我们确定了cavovarus足部的4种前足形态类型，这可能有助于外科医生识别和预测后足矫正后残留的前足畸形。不同的形态型可能需要不同的治疗策略以实现平衡的校正。
■四级，回顾性病例系列。
■我们纳入了16名接受过负重CT的Charcot-Marie-Tooth成年患者的20只脚（平均年龄43.4岁，范围：22-78岁，14名男性）。患者包括有柔性畸形，以前没有手术。使用专门的软件(Bonelogic2.1，Disior)三维，虚拟模型已创建。使用从没有病理学的患者的正常脚捕获的形态学数据作为指导，cavervarus足的距骨关节被数字化地缩小到“正常”位置，以模拟手术矫正过程中的矫正。输出校正位置的模型，并使用Blender3.64进行几何分析，以确定解剖趋势。
■我们确定了4种类型的cavovarus前足形态类型。0型被定义为平衡的前足(2例，10%)。1型被定义为前足，其中第一meta骨相对于脚的其余部分相对于足底弯曲，距骨关节矫正后无明显残余内收（12例，60%）。2型被定义为前足，其中第二和第一meta骨逐渐屈伸，无明显内收(4例，20%）。类型3被定义为前足，其中在距骨脱位后，meta骨被内收（2例，10%)。
■在这个相对较小的群体中，我们确定了cavovarus足部的4种前足形态类型，这可能有助于外科医生识别和预测后足矫正后残留的前足畸形。不同的形态型可能需要不同的治疗策略以实现平衡的校正。
■四级，回顾性病例系列。
