A Closer Look At Tendon Lengthening In Patients With Ankle Equinus

How can surgeons choose the most effective tendon lengthening procedure for patients with ankle equinus? These authors provide a detailed guide to various permutations of tendo-Achilles lengthening and gastrocnemius recession procedures, citing the advantages and disadvantages of each technique.

Ankle equinus is associated with a wide variety of foot and ankle conditions, and surgical treatment is common in conjunction with other treatments.

Physicians have historically used the Silfverskiold test to differentiate between gastrocnemius equinus and combined gastrocnemius-soleus equinus, which has implications for procedure selection.1 A positive Silfverskiold sign indicates ankle equinus that is present when the knee is extended but disappears when the knee is flexed, which indicates gastrocnemius equinus. Combined gastrocnemius-soleus equinus does not improve with flexion of the knee. Additional clinical signs of ankle equinus include genu recurvatum, hip flexion, lumbar hyperlordosis and forefoot overload.

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