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Flexible Deformity in Charcot-Marie-Tooth Disease
Charcot-Marie-Tooth (CMT) disease is an inherited progressive neuropathy encompassing a heterogeneous group of progressive and symmetric neurologic disorders of the extremities that have become more broadly known as hereditary motor-sensory neuropathies. The most common presentation of hereditary motor-sensory neuropathy is a progressive symmetric cavovarus foot deformity with instability and a footdrop gait. The hallmark of CMT is the selective weakness of the tibialis anterior, peroneus brevis, toe extensors, and intrinsic foot muscles, and the relative sparing of the antagonizing peroneus longus, tibialis posterior, and extrinsic toe muscles. This chapter reviews the surgical steps for correction of flexible foot deformities in CMT disease, including procedures for the correction of the plantarflexed first ray, correction of midfoot cavus and adduction, and correction of residual hindfoot varus.