RecruitingNCT06610591

Efficacy of Surgery for Idiopathic Toe Walking

Evaluating the Efficacy of Surgical Intervention for Idiopathic Toe Walking: A Prospective Cohort Pilot Study


Sponsor

University of Oxford

Enrollment

20 participants

Start Date

Sep 9, 2024

Study Type

OBSERVATIONAL

Conditions

Summary

BACKGROUND: For children who walk on their tip toes, surgery is often done to lengthen their Achilles Tendon. However, there is little research to help children's surgeons choose which children with idiopathic toe walking should have surgery. METHODS: This research study will investigate how effective surgery to lengthen the Achilles Tendon is for children with idiopathic toe walking. It will explore if the children\'s quality of life, endurance, strength, range of movement or walking pattern improves after they have had surgery. This study is a pilot study with 20 participants. This means the results will be used to decide if a larger trial is needed.


Eligibility

Min Age: 8 YearsMax Age: 16 Years

Inclusion Criteria4

  • Children aged 8-16 at recruitment.
  • Idiopathic toe walkers based on clinicians' assessment.
  • Plantarflexion contracture with knee extended of 0 degrees or less of dorsiflexion.
  • Listed for surgical lengthening of the plantarflexors.

Exclusion Criteria5

  • Unable to give informed assent or consent. Previous surgery to the lower limb.
  • Unable to effectively participate in gait analysis (e.g. unable to walk 10-metres unaided, unable to walk independently, allergy to adhesive for skin markers, hyperhidrosis).
  • Underlying diagnoses which may cause toe walking (e.g. muscular dystrophy, split cord malformation, cerebral palsy).
  • Listed for additional procedures in the surgery for the lengthening of the plantarflexors.
  • Awaiting further investigations or neurology assessment for toe walking pattern.

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Interventions

PROCEDUREAchilles Lengthening Surgery

The procedure is undertaken under general anaesthetic and involves horizontal hemi-section of the Achilles tendon via small 'stab' incisions at three levels to effect a lengthening of the tendon. The patient is then placed in a walking cast for four weeks thereafter. This surgery is usual care for most children with symptomatic ITW with plantarflexion contractures who have failed non-operative management.


Locations(2)

St George's University Hospitals NHS Foundation Trust

Tooting, London, United Kingdom

Oxford University Hospitals NHS Foundation Trust

Oxford, Oxfordshire, United Kingdom

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NCT06610591


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