Functional surgery plus rehabilitation versus physical exercise alone for Charcot-Marie-Tooth cavovarus foot deformity: a retrospective cohort study.

BACKGROUND

Charcot-Marie-Tooth (CMT) cavovarus foot deformity severely impairs walking. This study evaluated walking and functional outcomes in patients managed with functional surgery plus rehabilitation (FS) or physical exercise alone (PE).

METHODS

This retrospective matched cohort study included 109 CMT patients (55 FS, 54 PE) followed for 2 years. Primary outcomes were the 10-Meter and 6-Minute Walk Tests (10MWT, 6MWT). Secondary outcomes included walking disability (Walk-12, FADI), quality of life (SF-12), ankle mobility, and clinical symptoms.

RESULTS

In the FS group, 10MWT improved significantly at 6 months, 1 year, and 2 years (all p < 0.05). In the PE group, 10MWT improved significantly only at 6 months. 6MWT improved significantly in both groups at all follow-up points. At 2 years, the FS group showed significant reductions in falls (-21.8%; p = 0.019), callus formation (-16.4%; p = 0.026), and mobility aid use (-25.4%; p = 0.002), whereas the PE group showed no significant changes in these symptoms. CMTES remained unchanged in both groups.

CONCLUSIONS

In appropriately selected patients with CMT-related foot deformity, both treatments improved walking function in the short term. FS was also associated with sustained reductions in falls, calluses, and mobility aid use at 2 years, whereas PE showed no significant changes in these symptoms.