Excerpt:
Equinus deformity of the ankle is one of the most common problems encountered in cerebral palsy.1,2,3,4Equinus disrupts the gait cycle by decreasing stability in stance phase and causing inadequate clearance in swing phase.5,6 Nonoperative treatments for an equinus deformity of the ankle include stretching exercises, serial casting, bracing,7 and temporary or permanent denervation with botox,8,9 alcohol, or phenol.10Operative treatments include surgical denervation, Achilles tendon lengthening, gastrocnemius and/or soleus fascial lengthening, and anterior advancement of the Achilles insertion.11,12,13 Numerous heel cord-lengthening techniques have been described including tendon "slides" performed open or percutaneously, coronal Z-lengthening, and sagittal Z-lengthening.14,15,16,17 Three of the most common gastrocnemius lengthening techniques are those described by Baker,18 Strayer,19 and Vulpius.20 The Baker and Vulpius procedures may or may not include soleus fascial lengthening as well as gastrocnemius fascial lengthening.
No comments:
Post a Comment