This is an inverted position of the forefoot relative to the rearfoot at the level of the midtarsal joint. It is due to inadequate frontal plane torsion occurring during normal development of the foot. Upon weightbearing, calcaneal eversion is required to fully compensate this deformity. Ten to fifteen percent of patients treated with biomechanical problems have forefoot varus. This disorder causes some of the most severe pronation problems and foot deformities.

 

 

The three variations of forefoot varus seen are:

  1. Uncompensated: The rearfoot is rigid and cannot compensate. Instead of subtalar joint compensation, it will have to try to take place in the midtarsal joint.
  2. Partially Compensated: In this case the degree of forefoot varus is greater than the available degree of calcaneal eversion.
  3. Compensated: When the degree of forefoot varus is equal to or less than the degree of calcaneal eversion.

Forefoot Supinatus: Long-term compensatory calcaneal eversion can eventually twist the forefoot into a soft tissue or positional varus position of the forefoot relative to the rearfoot. This is not an osseous abnormality. It mimics forefoot varus. It will disappear with the use of foot orthotics.

Clinical observations and symptoms:

  • Intractable plantar keratoma’s 1, 2 and 4
  • Callus 1 and hallux
  • Plantar fasciitis
  • Neuroma
  • Hallux abducto valgus
  • Posterior tibial tendonitis
  • Low back pain