Congenital short tendo calcaneus.

It is common to see children who walk on their toes, and many different diseases are found to be the cause of this. During the past eight years we have recognised that some children, who appear to be otherwise normal, have a contracture of the calf muscles. We have not read of this condition in the literature and we call it congenital short tendo calcaneus. Between 1958 and 1964 twenty patients were treated by operation for this condition; fifteen were boys and in each case both legs were involved. The average age was seven and a half years. The children had always walked in this manner and although some of them could put their heels down when asked to do so, they found it more comfortable to walk on their toes. The chief complaint of parents was that the tread of their children’s shoes wore out without any sign of wear on the heels. Two families had more than one child affected but no other family history was obtained. Two children had been born prematurely but neither of them showed evidence of cerebral palsy. Examination did not reveal any deformity except equinus of both ankles from 30 to 60 degrees-with tightness of tendo calcaneus. The degree of deformity was not always symmetrical, and there was no muscle weakness or diminution of sensation ; and there were no changes in tone of muscle or tendon reflexes, locally or elsewhere in the body. Unlike other forms of tight calcaneal tendons these children looked like normal children walking on their toes.