Thanks
Orthopaedic Surgeon
If your son's ankle has now returned to a position of fixed equinus (ie foot pointing down), then there are a couple of options. A paediatric neurologist is a good suggestion, and they may be able to facilitate botox injections to relax the tight calf muscles, combined with serial casting of the leg with plaster/fibreglass to slowly bring the foot back up whilst stretching out the posterior muscles/tendons.
If serial casting fails, then he may require further surgery. This might involve lengthening of his gastrocnemius in isolation or his Achilles tendon, plus potentially the other posteromedial structures (tibialis posterior, FDL and FHL) - it all depends on what is tight. You would be best to see a foot and ankle specialist orthopaedic surgeon for this.
After a correction back to neutral is achieved (either non-operatively or with surgery), he will probably need to wear an ankle foot orthosis (AFO) in order to keep his ankle in a good position and prevent recurrence.
Talk to your GP to start the referral process in your new local area. Best of luck.
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