Wedge tarsectomy: For correction of isolated cavus deformity
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There are various disparate causes of a cavo-varus foot and ankle deformity all of which result in varying degrees of characteristic deformity secondary initially to imbalanced muscular action. The objective of all treatment, operative and non-operative, when dealing with foot and ankle deformity is to place (and hold) a balanced foot squarely beneath the tibia. The surgical management of such cases in particular is often referred to as “A La Carte, alluding to the very specific nature of individual interventions for individual components of the deformity (as opposed to any self-congratulatory dining following a successful surgical intervention) .
The indication for a Wedge tarsectomy is for correction of a comprehensive midfoot cavus. It is also possible to correct an element of adductus by excising an asymmetric tarsal wedge. If the excised tarsal wedge is truncated in its plantar aspect (in other words a wide based rather than sharp apex is cut) then secondary tightening of the plantar fascia is less likely to occur upon acute closure of the wedge.
Author: Mark Herron FRCS
Institution: The Wellington Hospital , London