Modified Caldwell procedure for correction of iatrogenic equinosupinatus deformity

This work describes a split gastrocnemius musculotendinous surgical transfer procedure that may be used to correct an equinosupinatus deformity. The procedure was used to realign the foot of a patient whose deformity was iatrogenically induced by an improperly placed gluteal injection. The injection caused symptoms consistent with a sciatic nerve lesion, with resulting denervation, multiple leg atrophy, ensuing muscle imbalance, and equinosupinatus deformity. Correction was obtained by passing the medial portion of the gastrocnemius tendon and muscle deep to the lateral portion, around the lateral border of the fibula, and into the third cuneiform bone. This, along with a Dwyer calcaneal osteotomy and multiple digital procedures, brought the foot to a more corrected position and enabled the patient to walk asymptomatically.