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Orthopaedic Proceedings
Vol. 85-B, Issue SUPP_III | Pages 206 - 206
1 Mar 2003
Stott N Walt S Lobb G Nicol R Austin N
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The purpose of the study was to document the outcome in adulthood of treatment for idiopathic toe walking.

Twenty of 23 adults who had been previously treated for idiopathic toe walking from 1984 to 1990 were contacted. Three of the 20 subjects lived outside Auckland and four subjects declined to participate, giving a total of 13 subjects suitable for study. All but one of the subjects had had serial casts between the ages of 3.7 to 9.5 years. Six subjects had no further treatment while the other seven subjects went on to surgical lengthening of either TA or calf (average age 10.7 years). All participants underwent 3-D gait analysis and heel-rise test. Average follow-up was 10.8 years (range 5.4–15.6 years). Three patients still had signs of toe walking on visual observation of their gait. The maximum ankle dorsiflexion in stance averaged 90 on 3-D gait analysis (range 20 to 140). Eleven subjects showed maximum ankle dorsiflexion in stance greater than 2 standard deviations below normative values. Nine subjects had abnormal timing of maximal ankle dorsiflexion in stance with maximum ankle dorsiflexion prior to 50 percent of the gait cycle. Only two patients had ankle push off powers below normative values of 2 watts/kg.

This is the first study to report on adults treated for idiopathic toe- walking as children. Most subjects showed restricted range and altered timing of ankle dor-siflexion in gait, however this was detectable visually in only three subjects.