Pes cavus deformities have long been known to be complicated and require extensive preoperative evaluation, intraoperative surgical acuity, and postoperative rehabilitation. The reconstructive algorithm includes varying combinations of soft tissue releases, tendon lengthening and transfers, and corrective osteotomies. This is a disease process that evolves with time, and patients may present at different stages of the deforming process depending on the etiology. Some etiologies are continually progressive, and this is important to consider when formulating a corrective plan. Also, some or all of the deformity may be rigid which also needs to be appreciated during procedure selection. This chapter aims to cover the full spectrum of cavus reconstruction procedures with technical pearls and pitfalls for each.
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