SURGICAL TREATMENT FOR IDIOPATHIC TOE WALKERS GIVES GOOD BIOMECHANICAL AND PATIENT SATISFACTION OUTCOMES

Introduction and Objective Idiopathic Toe Walking (ITW), a common gait abnormality in children, leads to functional limitations and psychosocial challenges. However, the lack of robust evidence to guide treatment results in varied clinical practice. This study aimed to evaluate the clinical and kinematic outcomes of children with ITW one year postoperatively and assess whether these align with patient and parent satisfaction. Method A retrospective review (2012–2023) assessed children diagnosed with ITW who underwent bilateral Tendon Achilles Lengthening (TAL). Clinical assessment and 3-dimensional gait analysis were used to assess kinematic parameters, generating a movement analysis profile (MAP) and gait profile score (GPS). Follow-up evaluations occurred one year post-operatively, supplemented by satisfaction surveys for a sub-cohort of patients. Results 39 patients (22 boys/17 girls) and 35 patients (20 boys/15 girls) had complete pre and postoperative data for clinical assessment and 3-dimensional gait analysis respectively. Age at the time of operation averaged 11.3 years. Postoperative follow-up averaged 1.3 years. Autism spectrum disorder was diagnosed in 23% of cases. Daytime pain reduced significantly from 72% preoperatively to 15%, while nighttime pain, reported in 10%, resolved entirely. Improvements were observed in ankle dorsiflexion and several MAP variables, suggesting better alignment with normative gait patterns. Additionally, GPS trends decreased postoperatively across the cohort. Patient and parent satisfaction outcomes were reported as excellent in 67% of responses. Conclusion The data suggests that TAL demonstrates efficacy in improving clinical and kinematic outcomes in ITW patients, reducing pain and achieving high levels of satisfaction among patients and parents.