The Impact of Operative Correction of Equinus in Cerebral Palsy on Gait Patterns

Abstract

Background: This study aimed to evaluate gait outcomes and strength following the surgical correction of equinus in cerebral palsy (CP) based on different surgical procedures. We included the Baumann and Strayer procedures, as well as the Achilles tendon lengthening (ATL). Methods: A retrospective analysis was performed in patients with infantile, bilateral CP who received instrumental 3D gait analysis before and after surgical correction (18.66 months postoperatively). Patients were divided into 3 groups: Strayer surgery, Baumann surgery, and ATL. Gait performance and muscle strengths were compared between studied surgeries. Results: A total population of 204 patients (15.43 years) with 341 operated lower limbs (LLs) was analyzed. Dorsiflexion in swing and stance phases significantly improved in all groups postoperatively. The Strayer and the ATL group showed higher postoperative dorsiflexion than the Baumann group. However, no loss of strength was observed with the Baumann method. Maximum power improved in this group postoperatively. An 8.2% loss in calf muscle strength was recorded in the Strayer group. Conclusion: Operative pes equinus treatment successfully improved the gait of children and adults with CP postoperatively. There were differences in postoperative results between studied operative techniques regarding range of motion and power. Level of Evidence: Level III, retrospective cohort study.

A bibliometric analysis of cerebral palsy from 2003 to 2022

“…Horsch evaluated gait outcomes and strength following different surgical procedures of the equinus foot in two groups of patients with CP and found that the Strayer procedure and Achilles tendon lengthening showed higher postoperative dorsiflexion. Moreover, an 8.2% loss in calf muscle strength was observed in the Strayer group, while in the Baumann procedure, no loss of strength was observed, and maximum power improved postoperatively ( 62 ). The hip is the second most commonly affected joint in patients with CP, thus hip surveillance programs are recommended to prevent, reduce, and identify hip dislocation ( 63 , 64 ).…”

The safety and efficacy of surgery for foot deformity in patients with Charcot-Marie-Tooth disease: a systematic review and meta-analysis

“…Notably, several studies explored the impact of surgical treatment on some speci c outcomes. Horsch et al 22 explored the impact of operative correction of equinus in CMT on gait patterns. They showed that Baumann surgery pes equinus treatment could signi cantly improve the gait of children and adults with cerebral palsy.…”