The Effect of Targeting the Plantaris Muscle-tendon in Surgical Correction of Ankle Equinus in Children

Launched by UNIVERSITY OF ALBERTA · Jul 22, 2025

Keywords

ClinConnect Summary

This clinical trial is studying a new approach to surgery for children who have tight ankle muscles causing difficulty in walking, a condition called ankle equinus. Usually, doctors focus on the large calf muscles to help improve ankle movement, but this study is looking at a smaller muscle in the leg called the plantaris. Researchers want to find out if treating this smaller muscle during surgery can help children move their ankles better and walk more easily.

Children aged 4 to 17 years who have certain conditions like cerebral palsy, idiopathic toe walking, or other nerve and muscle problems and are already scheduled for surgery to fix ankle equinus at Stollery Children’s Hospital may be eligible to join. Participants will have surgery where the plantaris muscle is lengthened either before or after the main calf muscles are treated. During surgery, doctors will measure how much the ankle can bend upward to see which approach works better. This study will help doctors understand if focusing on the plantaris muscle can improve treatment and long-term outcomes for kids with tight ankles.

Gender

ALL

Eligibility criteria

• Inclusion Criteria (All of the following criteria must be met):
• • Ability to provided informed consent/assent in English.
• • Pediatric patients (4-17 years) who have consented for surgery for the management of equinus contracture \* (either TA lengthening or GN recession) at the Stollery Children's Hospital
• • Known underlying diagnosis of any of the following: idiopathic toe walking, cerebral palsy, hereditary spastic paraparesis, traumatic brain injury, spinal cord injury/tethering, hereditary sensory-motor neuropathy, stroke
• • Ability to maintain hindfoot and midfoot neutral during assessment
• • Passive plantarflexion on affected side greater than 20° and greater than degree of equinus contracture.
• • Note: may be isolated or in conjunction with other orthopaedic procedures; in bilateral ankle equinus procedures, data will be collected bilaterally, but included as a single participant (i.e., single randomization).
• Exclusion Criteria (Any one or more of the following):
• • Unable to provide informed consent/assent in English.
• • Previous surgery for equinus
• • Limb deficiency on affected side
• • Knee flexion contracture of greater than 5°
• • Surgical intervention of the lower extremities below the affected knee in the last twelve months
• • BoNTA injections below the affected knee within the last six months
• • Known or suspected arthrofibrosis.