Equinovarus and drop foot deformities can be challenging to patients and physicians alike. The treatment of these complex pathologies aims to establish a plantigrade, painless, braceable, and ulcer-free foot and can be performed either in a staged or acute manner. Both neurologic and biomechanical etiologies have been implicated in these conditions; therefore both must be addressed carefully perioperatively. Surgical management of these problems may require a combination of tendon lengthening, tendon transferring, corrective osteotomies, and arthrodeses. Supple equinus contracture has been implicated in a myriad of foot and ankle conditions. Consistent and accurate clinical assessment of equinus cannot be overemphasized. In this chapter we focus on addressing these supple deformities with joint-preserving and tendon-balancing techniques.
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