Fig. 3A–B.

(A) Drop toe sign and a swollen foot with a proximally displaced heel pad are noted after casting elsewhere and three casts slipping off. (B) After a casting “break” of 3 weeks, swelling has resolved and the heel pad is in better position, but an extreme stiff equinus position remains. Early tendoachilles tenotomy is beneficial in feet with this much plantarflexion to prevent cast slippage.