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Equinus

The equinus is a deformity caused by an over-stretching of the foot in the upper ankle joint.

The patients walk only on the toes, because the sole and especially the heel do not reach the ground. May be congenital or acquired due to a paralysis, stroke, long bed rest without a prophylaxis or bad casts.

Treatment

The treatment can be tried conservatively with intensive physiotherapy, manual stretching and a forming gypsum.

Problem solving is usually better achieved operationally. The achilles tendon is extended and plantar ligaments are partly split. Sometimes even the calf muscles are lengthened. Cast immobilization for 6 weeks. In soft tissue corrections usually a significant increase in quality of life of mostly paralyzed patients is achieved.

Are the joints already stiffened, however, then operations on the joints (stiffening) or on the bones (wedge removals) are performed. The prospects for success must be evaluated in every particular case, as each patient comes with different operational requirements.

Example:


Equines

The foot axis is shown in red. It can not bent more (up or moved cephalad). The yellow line shows the normal range of ankle movement.




After surgery on both sides, the patient can walk much better despite the paralysis. The yellow foot and leg axis points ou the increase in mobility compared to the red line (mobility before surgery).