ABSTRACT
Congenital calcaneus deformity is usually part of calcaneovalgus, either seen as an isolated deformity or in association with congenital posteromedial bowing of the tibia. While congenital calcaneovalgus deformity usually resolves spontaneously during the first few weeks of life, all forms of paralytic calcaneus deformity tend to progress quite relentlessly throughout childhood. When there is a calcaneus deformity the normal pattern of the stance phase of gait is altered; the normal rockers are lost and the push-off is ineffective because the moment arm of gastrocsoleus is considerably reduced. Calcaneus deformity has a profound effect on the stability of the knee. In a child with a calcaneus deformity the knee can remain straight during the critical part of the stance phase when stability of the knee is essential, provided the quadriceps is functioning normally and the hamstrings are not spastic. In young children with paralytic calcaneus deformity, tenodesis of the Achilles tendon to the fibula can arrest progression of the deformity.
