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Simplified approach to idiopathic toe-walking
Insights
Percutaneous Achilles tendon lengthening effectively treats idiopathic toe-walking (ITW) in children. This outpatient procedure resulted in no recurrences and high parent satisfaction, simplifying ITW management.
Area of Science:
- Pediatric Orthopedics
- Neurosurgery
Background:
- Idiopathic toe-walking (ITW) presents treatment controversies.
- Current management strategies for ITW vary significantly.
Purpose of the Study:
- To evaluate the efficacy and outcomes of percutaneous Achilles tendon lengthening for idiopathic toe-walking.
- To assess long-term patient and parent satisfaction following the procedure.
Main Methods:
- Retrospective review of 15 children treated for ITW between 1993 and 1999.
- Outpatient percutaneous tendo-Achilles lengthening followed by 4 weeks of below-knee casting.
- Follow-up survey conducted with 10 of the 15 patients.
Main Results:
- No cases of toe-walking recurrence were reported by parents.
- All surveyed children could participate in activities without noticing calf weakness.
- Two patients experienced mild Achilles tendinitis, managed with anti-inflammatory medication.
- Overall parent satisfaction with the treatment outcome was high.
Conclusions:
- Percutaneous tendo-Achilles lengthening is a simplified and effective outpatient treatment for idiopathic toe-walking.
- The procedure demonstrates favorable long-term outcomes and high patient/parent satisfaction.
Abstract:
Controversy exists as to the treatment of idiopathic toe-walking (ITW). Since 1993, the authors have managed children with ITW using an outpatient percutaneous lengthening of the Achilles tendon, followed by placement of below-knee walking casts for 4 weeks. The authors reviewed 15 children who were treated for ITW with percutaneous Achilles tendon lengthening between 1993 and 1999. Ten of the 15 patients could be contacted for a follow-up survey. None of the parents stated that their child's toe-walking had recurred. There were no painful scars. All of the children were able to keep up with other children and did not notice any calf weakness. Two children had occasional Achilles tendinitis, which was relieved with antiinflammatory medications. All parents were satisfied with their child's outcome. The authors believe that percutaneous tendo-Achilles lengthening in ITW greatly simplifies the management of ITW.