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What pitfalls do providers run into when it comes to pediatric equinus?
 
Most providers are not checking for equinus consistently or in the most commonly accepted method, which is maximally supinating the foot as you dorsiflex the ankle. Subsequently, they are under-treating and not comprehensively treating their patients.
 
What is the literature demonstrating when it comes to this condition?
 
Equinus and its effects on the lower extremities have been documented in the literature for over 110 years and the research on this topic is robust, yet I would argue that is the most undertreated, overpublished pathology in the foot and ankle space.
 
What are the top interventions in your experience for pediatric equinus?
 
Stretching with a brace is very effective. I invented the Equinus Brace (IQ Med), so that is what I use and find to be effective. If I am operating on a pediatric patient I do a Baumann procedure unless the patient is an idiopathic toe walker; then I use a Strayer procedure because in this subset of patients the contracture is in the tendon, not the muscle like it usually is.
 
Dr. DeHeer is the Residency Director of the St. Vincent Hospital Podiatry Program in Indianapolis. He is a Fellow of the American College of Foot and Ankle Surgeons, a Fellow of the American Society of Podiatric Surgeons, a Fellow of the American College of Foot and Ankle Pediatrics, a Fellow of the Royal College of Physicians and Surgeons of Glasgow, and a Diplomate of the American Board of Podiatric Surgery.