Surgical treatment of equinus deformity in cerebral palsy by aponeurosis lengthening and Z-lengthening

Abstract

Surgical treatment of equinus deformity in cerebral palsy can be carried out successfully by Achilles tendon lengthening and gastrocnemius aponeurosis lengthening. From 1993 to 1998, we performed 59 operations in 37 cerebral palsied patients with equinus deformity using Z-lengthening in 30 cases and a modified Baker's procedure in 29 cases. The operations, associated with other hip and knee procedures in 65% of patients, were followed by postoperative use of casts and by a 12-month intensive kinesitherapeutic protocol. On preoperative evaluation, besides pattern deformity and the condition of proximal joints, we considered also age, clinical diagnosis, nature of tone and muscle strength. In most

The effects of serial casting on lower limb function for children with Cerebral Palsy: a systematic review with meta-analysis

“…Previous studies have supported the efficacy of interventions including BTX-A, diazepam and SDR for the management of spasticity [17,[21][22][23]. However, some previous research findings suggest that surgery for children with spasticity, if performed at a young age, can yield undesirable and sometimes unpredictable outcomes such as recurrent equinus, infection and overlengthening of muscle tendon units [22][23][24]. As a result, non-surgical interventions have been suggested clinically as temporising measures until the child is more musculo-skeletally developed [23].…”