A 25-year-old male presents with progressive bilateral foot deformity and recurrent lateral ankle sprains. He has difficulty with shoe wear and calluses under the first and fifth metatarsal heads. On examination, he has high-arched feet with hindfoot varus that corrects with Coleman block test. He has subtle weakness of ankle dorsiflexion and EHL.
What is the likely underlying diagnosis and what investigations would you perform?
What does the Coleman block test tell you and how does it guide treatment?
Describe your surgical approach for this patient.
What is the postoperative management and rehabilitation for cavovarus correction?
How do you manage progressive disease and the need for revision surgery?
What is the prognosis and expected functional outcome after surgical correction?
Opening Statement: This patient has bilateral cavovarus feet likely due to Charcot-Marie-Tooth disease. The positive Coleman block test indicates flexible hindfoot with forefoot-driven deformity. Surgical correction would address the plantarflexed first ray first, followed by soft tissue rebalancing and lateral ankle stabilisation.
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