Targeting the plantaris tendon during surgery to correct ankle equinus in children
The Effect of Targeting the Plantaris Muscle-tendon Unit in Surgical Correction of Ankle Equinus in Children
This trial tests whether cutting the small plantaris tendon, together with standard calf-lengthening surgery, helps children aged 4–17 with ankle equinus walk and use their feet better.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 42 (estimated) |
| Ages | 4 Years to 17 Years |
| Sex | All |
| Sponsor | University of Alberta Academic / other |
| Locations | 1 site (Edmonton, Alberta) |
| Trial ID | NCT07090057 on ClinicalTrials.gov |
What this trial studies
Children aged 4–17 with ankle equinus from conditions such as idiopathic toe walking or neuromotor disorders who are scheduled for calf-lengthening surgery at Stollery Children's Hospital will be enrolled. Participants are assigned to surgical approaches that either include a targeted plantaris tenotomy or do not, alongside standard tendoachilles lengthening or gastrocnemius recession, and outcomes are measured before and after surgery. Clinical measures include ankle range of motion, gait function, and calf muscle strength, with bilateral data collected when applicable but a single assignment per participant. The study seeks to determine whether targeting the plantaris alters recovery, strength recovery, and short- to medium-term walking outcomes.
Who should consider this trial
Good fit: Children aged 4–17 with ankle equinus (less than 10° dorsiflexion) who are scheduled for tendoachilles lengthening or gastrocnemius recession at the Stollery Children's Hospital and who meet the study's other clinical criteria are ideal candidates.
Not a fit: Children with fixed contractures, severe progressive neuromuscular disease, inability to maintain hindfoot or midfoot neutral, or who do not meet the passive plantarflexion criteria are less likely to receive benefit from this targeted intervention.
Why it matters
Potential benefit: If successful, adding plantaris release could improve ankle motion and walking function while reducing long-term weakness, need for bracing, or repeat procedures.
How similar studies have performed: The plantaris has been noted in small surgical reports as contributing to equinus but its role is poorly studied and no large trials have yet proven that targeting it improves outcomes.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria (All of the following criteria must be met): * Ability to provided informed consent/assent in English. * Pediatric patients (4-17 years) who have consented for surgery for the management of equinus contracture \* (either TA lengthening or GN recession) at the Stollery Children's Hospital * Known underlying diagnosis of any of the following: idiopathic toe walking, cerebral palsy, hereditary spastic paraparesis, traumatic brain injury, spinal cord injury/tethering, hereditary sensory-motor neuropathy, stroke * Ability to maintain hindfoot and midfoot neutral during assessment * Passive plantarflexion on affected side greater than 20° and greater than degree of equinus contracture. * Note: may be isolated or in conjunction with other orthopaedic procedures; in bilateral ankle equinus procedures, data will be collected bilaterally, but included as a single participant (i.e., single randomization). Exclusion Criteria (Any one or more of the following): * Unable to provide informed consent/assent in English. * Previous surgery for equinus * Limb deficiency on affected side * Knee flexion contracture of greater than 5° * Surgical intervention of the lower extremities below the affected knee in the last twelve months * BoNTA injections below the affected knee within the last six months * Known or suspected arthrofibrosis.
Where this trial is running
Edmonton, Alberta
- Stollery Children's Hospital — Edmonton, Alberta, Canada (Recruiting)
Study contacts
- Principal investigator: Sukhdeep Dulai, MD, MHSc, FRCSC — University of Alberta
- Study coordinator: Ailar Ramadi, PhD
- Email: Ailar.Ramadi@albertahealthservices.ca
- Phone: 780-492-2398
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.