title: Outcome after conservative and operative treatment of children with idiopathic toe walking: a systematic review of literature.
abstract: When toe walking persists after the age of 2 years in the absence of any neurological or orthopedic abnormalities, it is referred to as idiopathic toe walking (ITW). When the plantar flexion persists, an equinus contracture can develop. There is inconsistency in the treatment of choice of this condition. A systematic review of observational studies comparing cast and operative treatment of children with ITW or equinus contracture was undertaken. Ten trials involving 298 participants were included. Ankle dorsiflexion increased 3.1° (median follow-up 3 years) in the cast treatment group and 14.2° (median follow-up 3.3 years) in the surgical group. No significant differences between groups were found in terms of persistent toe walking and complications after treatment. We have found favorable results in improvement of dorsiflexion for children treated by surgery. However, due to heterogeneity of patient groups, sample size and follow-up, no firm conclusions on a favorable role of surgery or cast treatment could be drawn in the treatment of ITW or equinus contracture.
authors.affiliation: Department of Orthopaedic Surgery, Spaarne Hospital, Spaarnepoort 1-3, 2134 TM, Hoofddorp, The Netherlands, annelies_v_b@hotmail.com.
authors.forename: A F
authors.initials: AF
authors.lastname: van Bemmel
authors.forename: V A
authors.initials: VA
authors.lastname: van de Graaf
authors.forename: M P J
authors.initials: MP
authors.lastname: van den Bekerom
authors.forename: D A
authors.initials: DA
authors.lastname: Vergroesen
mesh_terms: D002370:Casts, Surgical; D002648:Child; D004863:Equinus Deformity / Q000601:surgery*; D005684:Gait; D006801:Humans; D019637:Orthopedic Procedures; D014034:Toes; D016896:Treatment Outcome