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Idiopathic Toe Walking: A Comparison of Treatment Methods

Stricker, Stephen J. M.D.; Angulo, Julie C. B.S.

Journal of Pediatric Orthopaedics: May-June 1998 - Volume 18 - Issue 3 - p 289-293

Eighty children with idiopathic toe walking (ITW) were examined 2-8 years(average, 34 months) after initial presentation to compare outcomes [passive ankle dorsiflexion (DF) and parental satisfaction] after three treatment modalities: observation, cast/brace treatment, or surgical triceps surae lengthening. Overall, 32% had a family history of ITW, 28% were born prematurely, and 16% had psychomotor delay. Forty-eight untreated patients showed little change in passive ankle DF at final follow-up, and only 25% of parents were satisfied with the child's gait. Compared with untreated children, casting/bracing appeared to offer no significant improvement in ankle DF or parental satisfaction. Surgical treatment was performed in 15 children with more severe equinus contractures. Triceps surae lengthening resulted in significantly improved ankle DF and 67% parental satisfaction(p < 0.05). Toe walking may persist after all standard treatment methods even in the absence of significant Achilles contracture.

From the Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, Jackson Memorial Medical Center, Miami, Florida, U.S.A.

Study conducted at Jackson Memorial Medical Center, Miami, Florida, U.S.A.

Address correspondence and reprint requests to Dr. S. J. Stricker, Department of Orthopaedic Surgery (D-27), P.O. Box 016960, Miami, FL 33101, U.S.A.

© Lippincott-Raven Publishers.