Varus foot in cerebral palsy: an overview.

In cerebral palsy, imbalance of the invertor and evertor muscles can result in varus alignment of the foot. The primary functional problems of varus foot are weightbearing instability and/or difficulty in foot clearance in swing phase. Additional problems include difficulties in shoe fitting, abnormal shoe wear, and unacceptable cosmesis. Gait studies have shed some light on the alterations of the muscle activity that can cause this problem but have fallen short of providing clear guidelines for treatment of this common problem. Confusion exists because dynamic electromyography does not give definitive information about the quantity of muscle tension and because the analyses have not included movement measurements that distinguish between the movements that occur in the hind foot and forefoot. Technical limitations that have made it impossible to obtain this information are rapidly disappearing, and the way is opening up for biomechanical studies of foot and ankle function that will allow greater precision in the selection of surgical treatment for varus foot.