An equinus or plantarflexed positioning of the calcaneus relative to the tibia often results in shortening of the Achilles tendon, gastrocsoleus complex, or both. This may result in a number of patient symptoms including abnormal gait, pain with weight bearing, toe walking, plantar forefoot callosities, and inability to properly fit into orthoses. When properly indicated, operative Achilles lengthening corrects fixed
ankle equinus that exists with the knee flexed as well as extended. The
ultimate goal is to improve ankle dorsiflexion, ideally to 10° of ankle
dorsiflexion past neutral with the knee flexed and 5° with the knee fully
extended. In this video, we discuss the clinical decision making, various
surgical techniques, and postoperative protocol of Achilles lengthening.