Supple Equinus, Equinovarus, and Drop Foot Surgical Strategies

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.