Fixed and Dynamic Equinus in Cerebral Palsy: Evaluation of Ankle Function After Multilevel Surgery

Equinus Correction During Multilevel Surgery in Adults With Cerebral Palsy

“…Also, patient-specific factors can influence the function postoperatively in a relevant way, the low number of patients (n = 31) does not statistically allow a multivariate analysis, and a large number of patients would be required to do so. Similar to other studies, [11][12][13]33,34 we compared our study group to an age-matched control group. However, the comparison with a real control group was not possible because of the retrospective design, which represents a further limitation of our study.…”

“…Studies in children showed satisfactory postoperative results after calf muscle lengthening procedures. 17,28,33,38 Medium-term follow-up including 3-dimensional gait analysis in children with spastic diplegic CP illustrates that calf muscle lengthening combined with multilevel procedures is a successful treatment after a mean of 7 years. 13 Long-term results (9-year follow-up) in ambulatory patients with diplegia indicate that gastrocnemius-soleus intramuscular aponeurotic recession in the context of SEMLS is an effective procedure to correct equinus.…”

“…13 Further mid-term and long-term results after gastrocnemius-soleus intramuscular aponeurotic lengthening as part of SEMLS provide satisfactory outcome. 12,13,29,33 The main goal in children with CP is to avoid a decrease of muscle strength of the triceps surae resulting in calcaneal gait and to strengthen the antagonists (eg, tibialis anterior muscle). 37 It is not clear, so far, if adults with CP show similar results after correction of equinus.…”

Three-Dimensional Gait Analysis in Children Undergoing Gastrocsoleus Lengthening for Equinus Secondary to Cerebral Palsy

“…Definitions of equinus were reported in thirteen studies [10][11][12][14][15][16][17][18][19][20][21][22][23] with various thresholds of sagittal ankle kinematics used. Eleven studies [9,11,14,16,[20][21][22][23][24][25][26] specified the inclusion of fixed equinus, but not all used the widely used Silfverskiold test. Seventeen [9,11,12,14,16,[18][19][20]24,[27][28][29][30][31][32][33][34] studies specified the CP subtype as spastic CP.…”

“…Fourteen studies reported swing phase kinematics [4,9,10,12,14,18,21,[23][24][25][26]33,35,36]. All studies reported significant increases in maximum or mean swing phase ankle dorsiflexion.…”