- Discussion:
- pattern of cerebral palsy influences type of foot & ankle deformities;
- ankle equinus:
- equinovarus:
- pes valgus:
- equinovalgus deformity:
- is more common in children w/ diplegia and spastic quadriplegia;
- in ambulatory children, mild deformity can be corrected w/ peroneal tendon lengthening (transfer of brevis to posterior tibialis is
unreliable) combined w/ achilles tendon lengthening;
- if heel valgus is pronouned, medial displacement os calcis osteotomy can be added;
- if heel valgus and forefoot pronation are marked, opening wedge osteotomy of the anterior calcaneal process can be performed;
- if hindfoot is in rigid valgus, it is best to combine an extra-articlar subtalar fusion with the tendon lengthening;
- more common in spastic diplegia;
- caused by spastic peroneals, contracted heel cords;
- peroneus brevis lengthening is helpful to correct moderate valgus;
- subtalar arthrodesis is reserved for severe valgus deformities;
- diff dx: toe walking
Chronologic outcome of surgical tendoachilles lengthening and natural history of gastroc-soleus contracture in cerebral palsy. A two-part study.
Equilibrium reactions in the feet of children with spastic cerebral palsy and of normal children.