eMedicine Specialties > Orthopedic Surgery > Foot & Ankle

Toe Walking: Follow-up

Author: Edwards P Schwentker, MD, Professor, Departments of Orthopedics and Rehabilitation and Pediatrics, Pennsylvania State College of Medicine
Contributor Information and Disclosures

Updated: Jan 22, 2009

Outcome and Prognosis

Patients with idiopathic toe walking who have spontaneously discontinued toe walking or who, following operative or nonoperative treatment, remain down on their heels for more than 1 year can be considered cured. Late recurrence is unlikely, and there should be no adverse late effects from any treatment employed.

The prognosis for patients with spasticity or paralytic muscle disease is less predictable. These patients deserve follow-up indefinitely, as recurrence remains a risk.

Future and Controversies

Some controversies exist regarding the use of gait analysis in diagnosis (see Other Tests).

 


More on Toe Walking

Overview: Toe Walking
Workup: Toe Walking
Treatment: Toe Walking
Follow-up: Toe Walking
Multimedia: Toe Walking
References

References

  1. Neptune RR, Burnfield JM, Mulroy SJ. The neuromuscular demands of toe walking: a forward dynamics simulation analysis. J Biomech. 2007;40(6):1293-300. [Medline].

  2. Sasaki K, Neptune RR, Burnfield JM, et al. Muscle compensatory mechanisms during able-bodied toe walking. Gait Posture. Jul 9 2007;[Medline].

  3. Westberry DE, Davids JR, Davis RB, de Morais Filho MC. Idiopathic toe walking: a kinematic and kinetic profile. J Pediatr Orthop. Apr-May 2008;28(3):352-8. [Medline].

  4. Armand S, Watelain E, Mercier M, et al. Identification and classification of toe-walkers based on ankle kinematics, using a data-mining method. Gait Posture. Feb 2006;23(2):240-8. [Medline].

  5. Katz MM, Mubarak SJ. Hereditary tendo Achillis contractures. J Pediatr Orthop. Nov 1984;4(6):711-4. [Medline].

  6. Fox A, Deakin S, Pettigrew G, Paton R. Serial casting in the treatment of idiopathic toe-walkers and review of the literature. Acta Orthop Belg. Dec 2006;72(6):722-30. [Medline].

  7. Hall JE, Salter RB, Bhalla SK. Congenital short tendo calcaneus. J Bone Joint Surg Br. Nov 1967;49(4):695-7. [Medline][Full Text].

  8. McMulkin ML, Baird GO, Caskey PM, Ferguson RL. Comprehensive outcomes of surgically treated idiopathic toe walkers. J Pediatr Orthop. Sep-Oct 2006;26(5):606-11. [Medline].

  9. Hemo Y, Macdessi SJ, Pierce RA, et al. Outcome of patients after Achilles tendon lengthening for treatment of idiopathic toe walking. J Pediatr Orthop. May-Jun 2006;26(3):336-40. [Medline].

  10. Green NE. The orthopaedic management of the ankle, foot, and knee in patients with cerebral palsy. Instr Course Lect. 1987;36:253-65. [Medline].

  11. Rosenthal RK. The use of orthotics in foot and ankle problems in cerebral palsy. Foot Ankle. Jan-Feb 1984;4(4):195-200. [Medline].

  12. Williams EA, Read L, Ellis A, et al. The management of equinus deformity in Duchenne muscular dystrophy. J Bone Joint Surg Br. Aug 1984;66(4):546-50. [Medline][Full Text].

Further Reading

Keywords

equinus contracture, idiopathic toe walking, habitual toe walking, congenital short Achilles tendon, muscle spasticity, paralytic muscle disorder, jumper's gait, neuromuscular disease, cerebral palsy, paralytic muscle disease, Duchenne muscular dystrophy

Contributor Information and Disclosures

Author

Edwards P Schwentker, MD, Professor, Departments of Orthopedics and Rehabilitation and Pediatrics, Pennsylvania State College of Medicine
Disclosure: Nothing to disclose.

Medical Editor

John S Early, MD, Foot/Ankle Specialist, Texas Orthopaedic Associates, LLP; Co-Director, North Texas Foot and Ankle Fellowship Baylor University Medical Center
John S Early, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Foot and Ankle Society, Orthopaedic Trauma Association, and Texas Medical Association
Disclosure: Zimmer Inc Consulting fee Independent contractor; Smith Nephew Consulting fee Independent contractor; AO North America Honoraria Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Shepard R Hurwitz, MD, Executive Director, American Board of Orthopaedic Surgery
Shepard R Hurwitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for the Advancement of Science, American College of Rheumatology, American College of Sports Medicine, American College of Surgeons, American Diabetes Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Association for the Advancement of Automotive Medicine, Eastern Orthopaedic Association, Orthopaedic Research Society, Orthopaedic Trauma Association, and Southern Orthopaedic Association
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Jason H Calhoun, MD, FAAOS, Chairman, J Vernon Luck Distinguished Professor, Department of Orthopedic Surgery, University of Missouri
Jason H Calhoun, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, and American Orthopaedic Foot and Ankle Society
Disclosure: Nothing to disclose.

 
 
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