Which tendon transfer is commonly used for correcting CMT-related foot deformity?

Which tendon transfer is commonly used for correcting CMT-related foot deformity?

• A. Flexor digitorum longus
• B. Tibialis posterior
• C. Peroneus brevis
• D. Achilles tendon

Answer: (B)

In Charcot‑Marie‑Tooth–related cavovarus foot deformity, the goal is to rebalance the hindfoot by reducing the strong inversion force that drives varus and arch collapse. The posterior tibial tendon is a powerful inverter of the foot, and in this setting its pulling pattern can perpetuate varus deformity. Transferring the posterior tibial tendon to a new insertion (often toward the dorsum or lateral aspect of the foot) changes its function enough to lessen hindfoot inversion and support the arch, helping achieve a plantigrade, more functional foot. This approach directly addresses the primary deforming force in many CMT cavovarus feet, and it can be performed in flexible deformities with or without additional procedures as needed. Other tendon transfers exist for cavovarus or flatfoot situations, but they don’t target the same dominant deforming force as reliably in CMT cases. For example, flexor digitorum longus transfers can assist in some contexts but don’t address hindfoot varus as directly, and peroneus brevis or Achilles tendon procedures carry different risks and mechanics that may not correct the primary inversion-dominant deformity.

In Charcot‑Marie‑Tooth–related cavovarus foot deformity, the goal is to rebalance the hindfoot by reducing the strong inversion force that drives varus and arch collapse. The posterior tibial tendon is a powerful inverter of the foot, and in this setting its pulling pattern can perpetuate varus deformity. Transferring the posterior tibial tendon to a new insertion (often toward the dorsum or lateral aspect of the foot) changes its function enough to lessen hindfoot inversion and support the arch, helping achieve a plantigrade, more functional foot. This approach directly addresses the primary deforming force in many CMT cavovarus feet, and it can be performed in flexible deformities with or without additional procedures as needed.

Other tendon transfers exist for cavovarus or flatfoot situations, but they don’t target the same dominant deforming force as reliably in CMT cases. For example, flexor digitorum longus transfers can assist in some contexts but don’t address hindfoot varus as directly, and peroneus brevis or Achilles tendon procedures carry different risks and mechanics that may not correct the primary inversion-dominant deformity.