Objective: To determine the outcome of Achilles tendon lengthening using Z-plasty in children with equinus feet.

Study Design: Descriptive study

Place and Duration of Study: Department of Orthopaedics, Peoples University of Medical & Health Sciences Shaheed Benazirabad from 1st January 2016 to 31st December 2019.

Methodology: Thirty seven patients were enrolled. Both male and female patients aged more than 4 years having hemiplegic or diplegic spastic cerebral palsy having a preoperative lateral view radiograph of involved ankle joint with ankle in maximum dorsiflexion and knee extended were included. Patients having history of surgery for equinus deformity on involved lower limb were excluded. Pain free plantigrade foot was the primary outcome measured. Z-plasty was performed under general anesthesia by an experienced orthopedic surgeon.

Results: Mean age was 7.43±2.10 years. There were 23 (62.1%) males and 14 (37.9%) were females. Twenty two (59.4%) had spastic hemiplegia and 15 (40.6%) had spastic diplegia. Surgery was performed on all the 52 feet affected. Following surgery 41 (78.8%) feet achieved plantigrade with pain relief. Correction was not adequate in 11 (21.2%) cases. Recurrence was observed in all the 11 (21.2%) cases with inadequate correction evident by progressive increase in equinus. Wound infection was seen in 12 (23.0%) cases.

Conclusion: Z-plasty for Achilles tendon-lengthening has a high success rate in treating equinus deformity and recurrence rate is high in patients with inadequate initial correction.

Keywords: Achilles tendon, Z-plasty, Equinus deformity