Introduction
Equinus deformity of the ankle is one of the most common deformities in children with cerebral palsy (CP). Triceps surae lengthening procedures include Achilles tendon-lengthening procedures and gastrocnemius recessions. Although both procedures result in improvements in ankle kinematics, there is no clear consensus on the best procedure.
Materials and methods
The study included 21 patients with ambulatory spastic CP with static equinus contracture who underwent 32 open distal gastrocnemius recessions. Fourteen patients had spastic diplegia, whereas seven patients had hemiplegia. The average age of the patients was 7.4 years (range 5-14), and the average follow up was 26 months (range 15-34). Outcome measures assessed preoperatively and postoperatively were passive dorsiflexion range of motion with the knee flexed and extended, dorsiflexion and plantarflexion strength, and calf spasticity with the knee flexed and extended in addition to the Gait Pattern Scale.
Results
All outcome measures showed a statistically significant improvement after gastrocnemius recession, except dorsiflexion and plantarflexion strength. Two limbs (6%) developed recurrence of equinus. No limbs developed overcorrection.
Conclusion
Gastrocnemius recession utilizing the technique described in this study has a satisfactory clinical outcome in ambulatory children with CP and clinically relevant gastrocnemius equinus contracture. The recurrence rate is acceptable in the short term.