Simplified approach to idiopathic toe-walking

Controversy exists as to the treatment of idiopathic toe-walking (ITW). Sin ce 1993, the authors have managed children with ITW using an outpatient per cutaneous lengthening of the Achilles tendon, followed by placement of belo w-knee walking casts for 4 weeks. The authors reviewed 15 children who were treated for ITW with percutaneous Achilles tendon lengthening between 1993 and 1999. Ten of the 15 patients could be contacted for a follow-up survey . None of the parents stated that their child's toe-walking had recurred. T here were no painful scars. All of the children were able to keep up with o ther children and did not notice any calf weakness, Two children had occasi onal Achilles tendinitis, which was relieved with antiinflammatory medicati ons. All parents were satisfied with their child's outcome. The authors bel ieve that percutaneous tendo-Achilles lengthening in ITW greatly simplifies the management of ITW.