title: Outcome of patients after Achilles tendon lengthening for treatment of idiopathic toe walking.
abstract: Fifteen children who were diagnosed with idiopathic toe walking that cannot be corrected by nonoperative treatment were assessed by clinical examination and computer-based gait analysis preoperatively and approximately 1 year after Achilles tendon lengthening. Passive dorsiflexion improved from a mean plantarflexion contracture of 8 degrees to dorsiflexion of 12 degrees after surgery. Ankle kinematics normalized, with mean ankle dorsiflexion in stance improving from -8 to 12 degrees and maximum swing phase dorsiflexion improving from -20 to 2 degrees. Peak ankle power generation increased from 2.05 to 2.37 W/kg but did not reach values of population norms. No patient demonstrated clinically relevant triceps surae weakness or a calcaneal gait pattern. Seven patients had a stance phase knee hyperextension preoperatively, and 6 of these corrected after surgery. Achilles tendon lengthening improves ankle kinematics without compromising triceps surae strength; however, plantarflexion power does not reach normal levels at 1 year after surgery.
authors: Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel.
authors: Yoram
authors: Y
authors: Hemo
authors: Samuel J
authors: SJ
authors: Macdessi
authors: Rosemary A
authors: RA
authors: Pierce
authors: Michael D
authors: MD
authors: Aiona
authors: Michael D
authors: MD
authors: Sussman