Operative Orthopädie und Traumatologie

, Volume 30, Issue 2, pp 130–146 | Cite as

Operative treatment algorithm for foot deformities in Charcot-Marie-Tooth disease

  • J. W. K. Louwerens
Surgical Techniques


The present article presents a short summary concerning the pathomechanisms and clinical presentation of foot deformities in Charcot-Marie-Tooth syndrome. Furthermore, a classification system is introduced and based on a recently performed review of the literature an operative treatment algorithm is provided. The operative technique of the following surgical procedures is described in more detail: 1. dorsiflexion osteotomy at the base of the 1st metatarsus, 2. dorsiflexion osteotomy at the base of a lesser metatarsal bone, 3. claw hallux correction including fusion of the first phalangeal joint, 4. claw toe correction, 5. transfer of extensor digitorum longus tendons to the peroneal tendons and finally 6. tibialis posterior tendon transfer to the dorsiflexors of the foot.


Tendon transfer Classification system Osteotomy Claw hallux Claw toe 

Algorithmus für die operative Behandlung von Fußdeformitäten bei der Charcot-Marie-Tooth-Krankheit


Der vorliegende Beitrag bietet eine kurze Zusammenfassung der Pathomechanismen und des klinischen Bilds von Fußdeformitäten bei der Charcot-Marie-Tooth-Krankheit. Ein Klassifikationssystem wird vorgestellt. Basierend auf einer kürzlich durchgeführten Literaturübersicht wird ein Algorithmus für die operative Behandlung vorgeschlagen. Die operativen Techniken folgender chirurgischer Verfahren werden detaillierter beschrieben: 1. Dorsalflexionsosteotomie an der Basis des ersten Mittelfußknochens, 2. Dorsalflexionsosteotomie an der Basis eines der anderen Mittelfußknochen, 3. Korrektur einer Krallenstellung der Großzehe einschließlich Fusion des ersten Phalangealgelenks, 4. Korrektur einer Krallenzehe, 5. Extensor-digitorum-longus-Transfer zu den Peronealsehnen und zuletzt 6. Transfer der Tibialis-posterior-Sehne zu den Dorsiflexoren des Fußes.


Sehnentransfer Klassifikationssystem Osteotomie Krallen hallux Krallenzehe 



Gratitude to Rudolf Stienstra (head of department of Anaesthesiology, St. Maartenskliniek, Nijmegen, NL) for writing the section concerning anaesthesia and to the colleagues of the Dutch guidelines study group, Viola Altmann (rehabilitation doctor) and the researchers Noël Keijsers and Cheriel Hofstad. Finally, my scrub nurse Birgitta van Cuyk-Kampschreur. All working at the St. Maartenskliniek, Nijmegen, NL.

Compliance with ethical guidelines

Conflict of interest

J.W.K. Louwerens declares that he has no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Foot and Ankle Reconstruction UnitSt MaartenskliniekNijmegenThe Netherlands

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