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ankle equinus

Dong Jin Ryu, Joon Mee Kim, Bom Soo Kim
Injury of the medial head of the gastrocnemius, also called "tennis leg," is known to heal uneventfully in most cases with compression and immobilization therapy. Failure to heal or long-term complications, including ongoing pain and pes equinus, have been documented in only a limited number of case reports. To the best of our knowledge, a severe concomitant contracture of the knee and ankle joint as a consequence of a maltreated gastrocnemius muscle rupture has not been previously reported in English-language reports...
November 17, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Claire M Capobianco
Triceps surae contracture, or equinus, is a known deforming force in the foot and ankle. Biomechanical studies have shown that ankle equinus significantly alters gait and plantar pressures, and in the diabetic neuropathic patient population, this can propagate plantar ulceration and/or Charcot neuroarthropathy (CN). Surgical correction of equinus is globally and frequently used to aid in plantar wound healing in the neuropathic diabetic patient, with and without CN. Treatment guidelines for equinus correction in this medically complex population are undefined and lack evidence from high-quality published peer-reviewed studies...
January 2017: Clinics in Podiatric Medicine and Surgery
Vivek S Chawathe, Anil K Gaur, Badrinath D Athani, Shefali Gupta
A 14-year-old boy reported with congenital deformity of the left lower limb, with gross shortening, hip and knee flexion deformities, ankle with equinus deformity, and polydactyly of the left foot. Radiologic examination showed proximal femoral focal deficiency, double fibula, and duplication of the tarsal bones, and a diagnosis of 'proximal femoral focal deficiency associated with fibular duplication and diplopodia with complete agenesis of tibia' was made. Such association of deformities is very rare and poses difficulties in rehabilitation of the case...
October 25, 2016: Journal of Pediatric Orthopedics. Part B
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Manuel Villanueva, Álvaro Iborra, Guillermo Rodríguez, Pablo Sanz-Ruiz
BACKGROUND: Isolated gastrocnemius contracture is thought to lead to numerous conditions. Although many techniques have been described for gastrocnemius recession, potential anesthetic, cosmetic, and wound-related complications can lead to patient dissatisfaction. Open and endoscopic recession techniques require epidural anesthesia, lower limb ischemia, and stitches and may lead to damage of the sural nerve, which is not under the complete control of the surgeon at all stages of the procedure...
October 3, 2016: BMC Musculoskeletal Disorders
H Sankaranarayan, Anupam Gupta, Meeka Khanna, Arun B Taly, K Thennarasu
OBJECTIVE: To study role of ankle foot orthosis (AFO) in improving locomotion and functional recovery after stroke. SETTING: Neurological Rehabilitation Department of a university research tertiary hospital. PATIENTS AND METHODS: AFO and activity based rehabilitation. MAIN OUTCOME MEASURES: Distance (meters) covered during the 6-minute walk test (6MWT) and speed (meter/second) during the 10-meter walk test. Functional abilities assessed using Functional Independence Measure (FIM(®))...
October 2016: Journal of Neurosciences in Rural Practice
Yu-Bin Liu, Shu-Yun Jiang, Li Zhao, Yan Yu, Xu-Chen Tao, Da-Hang Zhao
Background. This study was designed to evaluate the function of the foot undergoing the procedure of percutaneous Achilles tenotomy (PAT) in case of clubfoot management in terms of gait analysis. Methods. Nineteen patients with unilateral clubfeet were retrospectively reviewed from our database from July 2012 to June 2016. The result in all the cases was rated as excellent according to the scale of International Clubfoot Study Group (ICSG). The affected sides were taken as Group CF and the contralateral sides as Group CL...
2016: BioMed Research International
S T J Tsang, D McMorran, L Robinson, J Herman, J E Robb, M S Gaston
The aim of this study was to evaluate the outcome of combined tibialis anterior tendon shortening (TATS) and calf muscle-tendon lengthening (CMTL) in spastic equinus. Prospectively collected data was analysed in 26 patients with hemiplegic (n=13) and diplegic (n=13) cerebral palsy (CP) (GMFCS level I or II, 14 males, 12 females, age range 10-35 years; mean 16.8 years). All patients had pre-operative 3D gait analysis and a further analysis at a mean of 17.1 months (±5.6months) after surgery. None was lost to follow-up...
August 17, 2016: Gait & Posture
Evgenia Manousaki, Tomasz Czuba, Gunnar Hägglund, Louise Mattsson, Hanneke Andriesse
Relapse after successful initial correction of idiopathic clubfoot with the Ponseti method is often related to poor compliance with the foot abduction orthosis (FAO). The aim of this study was to evaluate treatment with custom-made dynamic orthoses. Twenty children with idiopathic clubfoot (30feet) who had been treated with dynamic orthoses after the correction phase according to the Ponseti casting technique were evaluated. Relapse rates during orthotic treatment were registered. A Vicon gait analysis system was used to measure gait parameters at the age of seven years...
August 7, 2016: Gait & Posture
James Amis
We are currently in the process of discovering that many, if not the majority, of the non-traumatic acquired adult foot and ankle problems are caused by a singular etiology: non-neuromuscular equinus or the isolated gastrocnemius contracture. There is no question that this biomechanical association exists and in time much more will be uncovered. There are three basic questions that must be answered: why would our calves tighten as we normally age, how does a tight calf, or equinus, actually cause problems remotely in the foot and ankle, and how do the forces produced by equinus cause so many seemingly unrelated pathologies in the foot and ankle? The purpose of this paper is to address the second question: how does a tight calf mechanically cause problems remotely in the foot and ankle? There has been little evidence in the literature addressing the biomechanical mechanisms by which equinus creates damaging forces upon the foot and ankle, and as a result, a precise, convincing mechanism is still lacking...
2016: Frontiers in Surgery
Emilie R C Williamson, Constantine A Demetracopoulos, Scott J Ellis
Few reports in the literature have described the conversion of a surgically fused ankle to a total ankle replacement. The takedown of an autofusion and conversion to a prosthesis has not been described. We report the case of a patient with severe rheumatoid arthritis with an ankle autofusion fixed in equinus and severe talonavicular arthritis that was converted to ankle replacement using the Salto XT revision system. We describe the reasons why the decision was made to perform total ankle arthroplasty while concomitantly fusing the talonavicular joint, and discuss the rationale of the various surgical treatment options considered...
September 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Razi Zaidi, Alexander J Macgregor, Andy Goldberg
OBJECTIVE: To report on the rate of 30-day readmission and the rate of additional or revision surgery within 12 months following total ankle replacement (TAR). DESIGN: A data-linkage study of the UK National Joint Registry (NJR) data and Hospital Episodes Statistics (HES) database. These two databases were linked in a deterministic fashion. HES episodes 12 months following the index procedure were isolated and analysed. Logistic regression was used to model predictors of reoperation and revision for primary ankle replacement...
May 23, 2016: BMJ Open
Frédéric Chantraine, Céline Schreiber, Elisabeth Kolanowski, Florent Moissenet
BACKGROUND AND PURPOSE: Abnormal knee hyperextension during the stance phase (genu recurvatum) is a common gait abnormality in persons with hemiparesis due to stroke. While ankle-foot orthoses (AFOs) are often used to prevent genu recurvatum by maintaining ankle dorsiflexion during the stance phase, AFOs reduce ankle joint mobility. Functional electrical stimulation (FES) is an alternative to the use of AFO for producing appropriately timed ankle dorsiflexion and with prolonged timing may also have value for reducing genu recurvatum...
July 2016: Journal of Neurologic Physical Therapy: JNPT
Céline Delvert, Pascal Rippert, Françoise Margirier, Jean-Pierre Vadot, Carole Bérard, Isabelle Poirot, Carole Vuillerot
BACKGROUND: Transverse-plane foot deformities are a frequently encountered issue in children with neurological disorders. They are the source of many symptoms, such as pain and walking difficulties, making their prevention very important. OBJECTIVES: We aim to describe the use and tolerability of a side pole static ankle foot orthosis used to prevent transverse-plane foot deformities in children with neurologic disorders. STUDY DESIGN: Monocentric, retrospective, observational study...
May 4, 2016: Prosthetics and Orthotics International
Alessandro Picelli, Marco Bacciga, Camilla Melotti, Elisabetta LA Marchina, Elisabetta Verzini, Federico Ferrari, Angelo Pontillo, Jessica Corradi, Stefano Tamburin, Leopold Saltuari, Claudio Corradini, Andreas Waldner, Nicola Smania
BACKGROUND: Despite the growing evidence about the use of robotic gait training in neurorehabilitation, there is a scant literature about the combined effects of this innovative technological approach and a first-line treatment for focal spasticity as botulinum toxin type A. In particular, to the best of our knowledge, no previous study evaluated if robotic gait training may enhance the antispastic effect of botulinum toxin type A. AIM: To evaluate the combined effects of robot-assisted gait training and botulinum toxin type A on spastic equinus foot in patients with chronic stroke...
April 21, 2016: European Journal of Physical and Rehabilitation Medicine
Patricia Morales-Muñoz, Raúl De Los Santos Real, Patricia Barrio Sanz, Jose Luis Pérez, Jesús Varas Navas, Javier Escalera Alonso
BACKGROUND: Gastrocnemius shortening causes an equinus deformity that may clinically manifest in foot disorders, including metatarsalgia. We use this term to describe pain localized to the metatarsal heads. The purposes of this prospective study were to review the effect of medial gastrocnemius proximal release on ankle dorsiflexion and assess the outcome of this technique on pain and functional limitations in patients who have mechanical metatarsalgia and isolated gastrocnemius shortening...
July 2016: Foot & Ankle International
Lisa C Drefus, Jocelyn F Hafer, David M Scher
BACKGROUND: It is critical to distinguish gait compensations from true abnormalities when planning interventions to improve gait in individuals with neuromuscular disorders. QUESTIONS/PURPOSES: The aim of this study was to determine the effect of isolated ankle equinus on knee kinematics during the initial contact phase of gait. METHODS: Ten healthy subjects (29 + 4.3 years) participated, and testing occurred in a motion analysis laboratory...
February 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Joseph J Ruzbarsky, David Scher, Emily Dodwell
PURPOSE OF REVIEW: The present review includes the most up-to-date literature on the causes, epidemiology, diagnosis, and treatment of toe walking. RECENT FINDINGS: The prevalence of toe walking at age 5.5 years is 2% in normally developing children, and 41% in children with a neuropsychiatric diagnosis or developmental delays. A recent systematic review concluded that there is good evidence for casting and surgery in the treatment of idiopathic toe walking, with only surgery providing long-term results beyond 1 year...
February 2016: Current Opinion in Pediatrics
Matthias C M Klotz, Daniel W W Heitzmann, Sebastian I Wolf, Mirjam Niklasch, Michael W Maier, Thomas Dreher
Recent reports have shown that timing of genu recurvatum (GR) might be caused by different underlying factors and that equinus leads to GR especially during early stance. The purpose of this study was to investigate the reduction of GR after surgical correction of equinus in children with bilateral spastic cerebral palsy and whether the children with early and late type GR show differences in reduction of knee hyperextension after a surgery. In 24 limbs (mean age 10.3 years, GMFCS I-III) showing equinus and GR the kinematics of the knee and ankle as well as the kinetics of the knee were evaluated before and one year (mean follow up period: 12...
January 2016: Research in Developmental Disabilities
Mark T Tagoe, Neil D Reeves, Frank L Bowling
Patients with diabetes and ankle equinus are at particularly high risk for forefoot ulceration because of the development of high forefoot pressures. Stiffness in the triceps surae muscles and tendons are thought to be largely responsible for equinus in patients with diabetes and underpins the surgical rationale for Achilles tendon lengthening (ATL) procedures to alleviate this deformity and reduce ulcer risk. The established/traditional surgical approach is the triple hemisection along the length of the Achilles tendon...
January 2016: Diabetes/metabolism Research and Reviews
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