Treatment of symptomatic foot and ankle deformities in the nonambulatory neuromuscular patient.

Thirteen nonambulatory patients, aged 7 to 15 years and with neuromuscular disease, had residual foot and ankle deformities secondary to persistent and continued muscular imbalance around the ankle and foot. Surgical procedures were done to correct these fixed contractures so that the ankle was neutral and the foot plantigrade at the conclusion of the procedures. Despite successful attainment of the preoperative objectives, surgery should not be performed unless the following indications are present: severe pain, skin breakdown and/or ulceration, and the inability for the foot and ankle to accept reasonably costing and available shoe wear. Recurrence occurs if AFOs (ankle-foot orthoses) are not used after the surgical releases.