Document Detail


Outcomes of gastrocnemius-soleus complex lengthening for isolated equinus contracture in children with cerebral palsy.
MedLine Citation:
PMID:  20104161     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The goal of the gastrocnemius-soleus complex (GSC) lengthenings in children with cerebral palsy (CP) is to achieve a plantigrade foot and normalize kinematics during gait. The study purpose was to evaluate the results of GSC lengthening for isolated equinus contracture in individuals with CP. It was hypothesized that GSC lengthenings would normalize passive ankle range of motion, kinematic, kinetic, and temporal spatial parameters. METHODS: Gait data from 15 able-bodied participants from the laboratory normal database and passive range of motion, kinematic, kinetic, and temporal spatial gait parameters, and oxygen cost were collected and analyzed for 27 individuals with CP (36 limbs) with isolated equinus contracture who received GSC lengthenings. Data were compared between preoperative and postoperative assessments. RESULTS: Mean age at baseline was 11.4 years (+/-3.2 y). Mean time between surgery and postoperative gait analysis was 1.3 years (+/-0.3 y). Passive range of motion measurements were obtained. Kinematic and kinetic data for the hip, knee and ankle, and temporal spatial parameters were obtained from a representative gait trial preoperatively and postoperatively. Paired t tests (P<0.05) determined whether preoperative data differed from postoperative data or from able-bodied data. The passive range of motion at the ankle was improved and normalized postoperatively. Ankle kinematics normalized without compensatory changes occurring at the knee or hip kinematics. Ankle moments and powers become more normal but did not completely normalize. Kinematics and kinetics of the hip and knee were not adversely affected. No changes in the temporal spatial data or oxygen cost occurred postoperatively. CONCLUSIONS: These data support the finding that with appropriate patient selection isolated GSC lengthening does not result in overcorrection. LEVEL OF EVIDENCE: Retrospective comparative study; level 3.
Authors:
Chester M Tylkowski; Mike Horan; Donna J Oeffinger
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  29     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:    2009 Oct-Nov
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  771-8     Citation Subset:  IM    
Affiliation:
Shriners Hospital for Children, and Department of Orthopedics, University of Kentucky, Chandler Medical Center, College of Medicine, Lexington, KY 40502, USA. ctylkowski@shrinenet.org
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MeSH Terms
Descriptor/Qualifier:
Ankle Joint / physiopathology,  surgery
Biomechanics
Cerebral Palsy / physiopathology*,  surgery*
Child
Clubfoot / physiopathology*,  surgery*
Female
Gait Disorders, Neurologic / physiopathology*,  surgery*
Humans
Male
Muscle, Skeletal / surgery*
Range of Motion, Articular / physiology
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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