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Supple Equinus, Equinovarus, and Drop Foot Surgical Strategies

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Essential Foot and Ankle Surgical Techniques

Abstract

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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Abbreviations

EDL:

Extensor digitorum longus

EHL:

Extensor hallucis longus

GR:

Gastrocnemius recession

GSR:

Gastrocsoleus recession

PT:

Posterior tibial

TA:

Tibialis anterior

TAL:

Tendo-Achilles lengthening

References

  1. Anderson JG, Bohay DR, Eller EB, Witt BL. Gastrocnemius recession. Foot Ankle Clin. 2014;19(4):767–86.

    Article  Google Scholar 

  2. Cho B-K, Park K-J, Choi S-M, Im S-H, SooHoo NF. Functional outcomes following anterior transfer of the tibialis posterior tendon for foot drop secondary to peroneal nerve palsy. Foot Ankle Int. 2017;38(6):627–33.

    Article  Google Scholar 

  3. Cychosz CC, Phisitkul P, Belatti DA, Glazebrook MA, Digiovanni CW. Gastrocnemius recession for foot and ankle conditions in adults: evidence-based recommendations. Foot Ankle Surg. 2015;21(2):77–85.

    Article  Google Scholar 

  4. Digiovanni CW, Kuo R, Tejwani N, et al. Isolated gastrocnemius tightness. J Bone Joint Surg Am. 2002;84-A(6):962–70.

    Article  Google Scholar 

  5. Jastifer JR, Marston J. Gastrocnemius contracture in patients with and without foot pathology. Foot Ankle Int. 2016;37(11):1165–70.

    Article  Google Scholar 

  6. Johnson JE, Paxton ES, Lippe J, et al. Outcomes of the bridle procedure for the treatment of foot drop. Foot Ankle Int. 2015;36(11):1287–96.

    Article  Google Scholar 

  7. Pinney SJ, Sangeorzan BJ, Hansen ST. Surgical anatomy of the gastrocnemius recession (Strayer procedure). Foot Ankle Int. 2004;25(4):247–50.

    Article  Google Scholar 

  8. Richardson DR, Gause LN. The bridle procedure. Foot Ankle Clin. 2011;16(3):419–33.

    Article  Google Scholar 

  9. Silfverskiold NI. Reduction of the uncrossed two-joints muscles of the leg to one-joint muscles in spastic conditions. Acta Chir Scand. 1924;56(315):1923–4.

    Google Scholar 

  10. Silver CM, Simon SD. Gastrocnemius-muscle recession (Silfverskiold operation) for spastic equinus deformity in cerebral palsy. J Bone Joint Surg Am. 1959;41-A:1021–8.

    Article  CAS  Google Scholar 

  11. Steinau HU, Tofaute A, Huellmann K, et al. Tendon transfers for drop foot correction: long-term results including quality of life assessment, and dynamometric and pedobarographic measurements. Arch Orthop Trauma Surg. 2011;131(7):903–10.

    Article  Google Scholar 

  12. Tashjian RZ, Appel AJ, Banerjee R, Digiovanni CW. Endoscopic gastrocnemius recession: evaluation in a cadaver model. Foot Ankle Int. 2003;24(8):607–13.

    Article  Google Scholar 

  13. Yeap JS, Birch R, Singh D. Long-term results of tibialis posterior tendon transfer for drop-foot. Int Orthop. 2001;25(2):114–8.

    Article  CAS  Google Scholar 

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Brandão, R.A., McGann, M.R., Bull, P.E. (2019). Supple Equinus, Equinovarus, and Drop Foot Surgical Strategies. In: Hyer, C., Berlet, G., Philbin, T., Bull, P., Prissel, M. (eds) Essential Foot and Ankle Surgical Techniques. Springer, Cham. https://doi.org/10.1007/978-3-030-14778-5_31

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  • DOI: https://doi.org/10.1007/978-3-030-14778-5_31

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-14777-8

  • Online ISBN: 978-3-030-14778-5

  • eBook Packages: MedicineMedicine (R0)

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