No abstract available.
Cerebral Palsy* ; Equinus Deformity*

No abstract available.
Cerebral Palsy* ; Equinus Deformity* ; Heel* ; Muscle Spasticity*

Equinus contracture of the gastrocnemius-soleus complex is associated with many foot and ankle diseases. We introduce a new simple technique that can be performed using a minimal incision with simple devices. Briefly, 0.5 cm sized medial and lateral longitudinal skin incisions are made at the level of the distal one third of the calf. The musculotendinous junction of the gastrocnemius is gently transected using an Arachnoid blade. The skin is, then, closed with non-absorbable sutures.
Animals ; Ankle ; Arachnoid ; Equinus Deformity ; Foot ; Skin ; Sutures

Joint deformity secondary to neoplastic involvement of the soft tissue has been well described and is easy to diagnose. Mesenchymema is a rare neoplasm which can arise at anyplace of the body and called as angiomyolipoma, lipomyohemangioma, fibromyxolipoma and etc. according to the composition of the various tissues. We experienoed a case of equinus deformity due to mesenchymoma of calf muscle. The patient was treated by excision and tendo calcaneus lengthening with satisfactory result.
Achilles Tendon ; Angiomyolipoma ; Congenital Abnormalities ; Equinus Deformity ; Humans ; Joints ; Mesenchymoma

Vascular malformations may typically present with palpable mass that can be either asymptomatic or can present with symptoms including swelling and pain. On rare occasions, vascular malformation of muscle may produce joint deformities caused by contracture of the involved muscle. When vascular malformation involves the flexor muscle of the leg, ankle equinus deformity may occur. However, there are no reports of toe deformities secondary to intermuscular or intramuscular vascular malformations of flexor muscles of toe. Thus, we report a case of vascular malformation of flexor hallucis longus muscle with flexion contracture of toes in a 40-years-old woman who was treated with surgical excision.
Animals ; Ankle ; Congenital Abnormalities ; Contracture ; Equinus Deformity ; Female ; Humans ; Joints ; Leg ; Muscles ; Toes ; Vascular Malformations

PURPOSE: The purpose of this study was to evaluate the post-operative changes and to determine the factors affecting results obtained after surgical correction of spastic equinus deformity. MATERIALS AND METHODS: Among cerebral palsy patients who had received Tendo Achilles Lengthening (TAL) or the Strayer procedure, eighty nine patients (114 cases: TAL, 78 cases and Strayer, 36 cases) were included in this study. We evaluated clinical assessment data, kinematic data, and kinetic data pre- and post-operatively, according to the geographic type of cerebral palsy, age at operation, and sex. RESULTS: Clinically, equinus deformities were corrected with an increased passive range of motion of the ankle in both groups. Accord-ing to the kinematic results, both groups showed a normal ankle motion pattern with an increased dynamic range of motion. Kinetic results revealed that peak plantarflexor moment and power generation (A2) increased in both groups and that this increase was statisti-cal significant in TAL group. CONCLUSION: Both the TAL and Strayer procedures corrected the spasticity and equinus deformity, and resulted in an increased dynam-ic range of motion of the ankle joint without compromising the triceps power. However, care must be taken not to decrease power gen-eration when TAL is performed in diplegic cases older than 13 years of age.
Ankle Joint ; Ankle* ; Cerebral Palsy ; Equinus Deformity* ; Humans ; Muscle Spasticity* ; Range of Motion, Articular

Talipes equinovarus deformity associated with arthrogryposis multiplex congenita(AMC) is rigid and its treatment is still controversial. The purpose of this study is to review the trend of recurrence after soft tissue release, and to delineate the risk factors affecting recurrence. Forty-one clubfeet in 24 AMC patients underwent soft tissue release as the first operation at the average age of 1 year 2 months (range, 6 months - 5 years 11 months) and were followed up for an average of 5 year 6 months (range, 2 years 1 month 14 years 5 months). Types of soft tissue release were Turcos posteromedial release (PMR) in 26 cases and posteromediolateral release (PMLR) using the modified Cincinati incision in 15 cases. Recurrences occurred in seventeen clubfeet (41%). A variety of recurrent deformity was corrected by redo PMR or PMLR, osteotomy, talectomy, arthrodesis, or Ilizarov technique. Average number of operations was 1.5 per case. Four parameters were analyzed in relation to recurrence: type of arthrogryposis, initial equinus deformity, type of primary soft tissue release, and age at the first operation. Recurrence occurred in proportion to the severity of initial equinus deformity, and was more frequent in amyoplasia type than in distal arthrogryposis type. However, neither the type of soft tissue release nor the age at the first operation was significant contributing factor to recurrence.
Arthrodesis ; Arthrogryposis* ; Clubfoot* ; Congenital Abnormalities ; Equinus Deformity ; Humans ; Ilizarov Technique ; Osteotomy ; Recurrence* ; Risk Factors

OBJECTIVETo explore clinical efficacy of osteotomy and fusion in treating severe rigid equinus deformity.

METHODSFrom April 2010 to October 2015, 13 patients(16 feet) with severe rigid equinus deformity were treated with osteotomy and fusion by hollow screw, including 6 males and 7 females aged from 39 to 62 years old with an average of(49.6±5.3) years old;the courses of diseases ranged from 5 to 27 years with an average of (9.0±4.8) years. Six patients (9 feet) were treated with osteotomy and fusion for three joints, 4 patients(4 feet) were treated with osteotomy and fusion for four joints, and 3 patients (3 feet) were treated with osteotomy and fusion for tibiotalar and calcaneal-talar joints. All patients manifested as foot pain, heel could not touch floor and walking before operation. Postoperative complications were observed, AOFAS score were applied to evaluate clinical effect.

RESULTSThirteen patients were followed up from 18 to 24 months with an average of 20 months. Only one patient occurred local skin necrosis after operation and healed by dressing change and anti-infective therapy. All feet obtained fracture healing, the time ranged from 12 to 16 weeks with an average of 13.2 weeks. AOFAS score were improved from 11.85±10.66 before operation to 81.38±3.69 after operation, and had significant difference(=-25.67, <0.05);15 feet good and 1 foot moderate.

CONCLUSIONSTibiotalar and calcaneal-talar joint fusion, osteotomy and fusion for three and four joints could treat severe rigid equinus deformity according to patients' individual and could obtain satisfied clinical effects.

Adult ; Arthrodesis ; Calcaneus ; pathology ; Equinus Deformity ; surgery ; Female ; Humans ; Male ; Middle Aged ; Osteotomy ; Treatment Outcome

PURPOSE: To measure the muscle length of the gastrocnemius and soleus during gait in CP patients with an equinus deformity before and after surgery. MATERIALS AND METHODS: Twelve CP patients with an equinus deformity (17 limbs) were examined by gait analysis preoperatively and postoperatively. The patient group was further classified into the TAL and Strayer group according to the surgical technique. The mean age and mean follow-up periods were 14.3 years (5-25 years) and 15.3 months (12.5-18.5 months), respectively. The muscle length of the Gastrocnemius and Soleus was measured during gait using the SIMM program linked to a gait analysis system. RESULTS: The ankle ROM, knee ROM, maximal muscle length and peak-to-peak excursion during gait improved after surgery. There was a significant difference between the preoperative and postoperative measurements (p<0.05), but no difference between the postoperative and control groups (p>0.05). The muscle length of the soleus was elongated during gait after the Strayer procedure. CONCLUSION: Patients with an equinus deformity had a contracted triceps muscle, which was elongated after surgery. These changes were quantified by a comparison of the preoperative and postoperative measurements.
Animals ; Ankle ; Cerebral Palsy ; Contracts ; Equinus Deformity ; Follow-Up Studies ; Gait ; Humans ; Knee ; Muscle, Skeletal ; Muscles

OBJECTIVE: The aim of this study was to identify the changes of pressure distribution on the foot after orthopaedic surgery for equinus deformity in spastic cerebral palsy using F-scan system. METHOD: Twenty-one children with spastic cerebral palsy were participated in this study. They had equinus deformity on foot and received soft tissue surgery. Pressure distribution on foot was measured before and after operation using F-scan system (Tekscan Inc., USA). Paired t-test was used in comparison of preoperative and postoperative measurements for statistical analysis. RESULTS: Total contact area, contact length, midfoot and hindfoot contact width were significantly increased after operation. Relative impulses of medial and lateral forefoot were significantly decreased and relative impulse of hindfoot significantly increased after operation (p<0.05). Anteroposterior distance of center of pressure (COP) and velocity of COP were significantly increased and mediolateral distance and slope of COP were significantly decreased after operation (p<0.05). CONCLUSION: This study revealed that patterns of foot pressure distribution during walking were significantly improved after operation. Therefore, these findings suggested that F- scan system might be useful for surgical outcome measurement for foot deformities in the children with spastic cerebral palsy.
Cerebral Palsy* ; Child ; Equinus Deformity* ; Foot Deformities ; Foot* ; Humans ; Muscle Spasticity* ; Walking