Chronologic outcome of surgical tendoachilles lengthening and natural ³

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history of gastroc-soleus contracture in cerebral palsy. A two-part study. Á Damron TA. Greenwald TA. Breed AL. Clinical Orthopaedics & Related Research. (301):249-55, 1994 Apr. Medical records of 59 patients with cerebral palsy were reviewed retrospectively to evaluate results of tendoachilles lengthening. Surgical lengthening resulted in highly significant (p < 0.0001) initial average gains in dorsiflexion compared with baseline. These average improvements maintained their statistical significance for seven years postoperatively. Á The arc of motion was not significantly different postoperatively. The  initial ambulatory level was improved in 55% of the patients and maintained in the remainder. However, 14 ankles (11.9%) in eight patients (13.6%) required repeat tendoachilles lengthening during the study period, primarily after gastrocnemius procedures. Calcaneus deformity occurred in 1.7% of the surgically treated ankles. To evaluate the potential for spontaneous improvement over time in fixed equinus deformity, the records of a group of 68 additional cerebral palsy patients were reviewed. Patients treated nonoperatively despite two examinations that demonstrated fixed lack of dorsiflexion, while not representing a true control group, showed no spontaneous improvement in equinus deformity through seven years postoperatively. *