**7.2 Equinus**

This deformity is also associated with higher levels of spina bifida. If the deformity is flexible an AFO may be attempted to prevent further progressing to a rigid equinus (**Figure 11**). With increasing severity of the deformity an Achilles tendon excision is recommended and even a radical posterior release if a plantigrade foot is not achieved after the Achilles resection [40]. Once the foot is an acceptable position a K wire is used in the talocalcaneal joint to maintain the alignment while to foot remains in a cast for at least 6 weeks (**Figure 12**).
