Surgical Procedures

  • Pure equinus:  Lengthening of the Achilles tendon.

    2.2-ProcedQuirur1
  • Appearance of irreducible flexion of the toes: Lengthening of the Achilles tendon + myotenotomy of FHL (flexor hallucis longus) and FDL (flexor digitorum longus) muscles.

    2.2-ProcedQuirur2
  • Persistent toe flexion: assess performing capsulotomies and resection of distal flexors.
  • Varus deformity of the foot due to hypertonic tibialis anterior or tibialis posterior (whether static or dynamic): Lengthening of Achilles + tibialis anterior or tibialis posterior transfer with bone anchorage or suture to the peroneus brevis.

    2.2-ProcedQuirur3

 

POST-SURGICAL TREATMENT

  • In lengthening due to slippage of the Achilles tendon, weight can be placed on the leg after 3-4 weeks and day- and night-time splints must be used continually for 5 weeks. After this, they can be gradually removed, maintaining night-time splints for around 6 months.
  • In transfers, whether with tendon sutures or bone anchorage, no weight can be placed on the leg for 5 weeks. In this case, a splint will be placed after 5 weeks, with gradual daytime removal, maintaining night-time splints for around 6 months.