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Equinus deformity is a common condition that plays a significant role in the development of numerous lower extremity pathologies. In the pediatric patient, equinus deformity has historically been associated with neurological conditions. Equinus in the non-neurological patient is prevalent, especially in those patients with lower extremity biomechanically related pathologies. Defining equinus based on the literature is the initial requirement to understand, evaluate, and treat the deformity. Ankle joint dorsiflexion ≤ − 5° with the foot maximally supinated and the knee fully extended is a definition based on evidence-based medicine (Gatt, Foot 30:47–52, 2017). The anatomy of the gastrocsoleus complex, especially that of the gastrocnemius muscle crossing the knee, ankle, and subtalar joints, and its functions during the gait cycle can result in biomechanical abnormalities when abnormally tight. Compensation for an equinus deformity occurs distally with dampening of the peroneus longus tendon function leading to midtarsal hypermobility and plantarflexion of the naviculocuneiform joint. The distal and lateral movement of the center of pressure relative to the subtalar joint axis results in a net increased pronatory moment on the foot. This distal compensation for equinus deformity leads to numerous lower extremity pathologies. Management of any condition with an underlying equinus component must include treatment of the equinus deformity. This treatment may be either nonsurgical or surgical, but it must be part of the global deformity management. |
