Supple Equinus, Equinovarus, and Drop Foot Surgical Strategies

  • Roberto A. Brandão
  • Maria Romano McGann
  • Patrick E. Bull


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.


Achilles contracture Equinus Neurologic disorders Residual clubfoot Varus deformity 



Extensor digitorum longus


Extensor hallucis longus


Gastrocnemius recession


Gastrocsoleus recession


Posterior tibial


Tibialis anterior


Tendo-Achilles lengthening


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Roberto A. Brandão
    • 1
  • Maria Romano McGann
    • 2
  • Patrick E. Bull
    • 3
  1. 1.The Centers for Advanced OrthopaedicsOrthopaedic Associates of Central Maryland DivisionCatonsvilleUSA
  2. 2.Romano Orthopaedic CenterOak ParkUSA
  3. 3.Orthopedic Foot & Ankle CenterWorthingtonUSA

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