Yonsei Med J.  2006 Oct;47(5):657-666. 10.3349/ymj.2006.47.5.657.

Soft Tissue Surgery for Equinus Deformity in Spastic Hemiplegic Cerebral Palsy: Effects on Kinematic and Kinetic Parameters

• Park CI
• Park ES
• Kim HW
• Rha DW

• KMID: 1381246
• DOI: http://doi.org/10.3349/ymj.2006.47.5.657

Abstract

The purpose of this study was to evaluate how soft tissue surgery for correcting equinus deformity affects the kinematic and kinetic parameters of the ankle and proximal joints. Sixteen children with spastic hemiplegic cerebral palsy and equinus deformities (age range 3-16 years) were included. Soft tissue surgeries were performed exclusively on the ankle joint area in all subjects. Using computerized gait analysis (Vicon 370 Motion Analysis System), the kinematic and kinetic parameters during barefoot ambulation were collected preoperatively and postoperatively. In all 16 children, the abnormally increased ankle plantar flexion and pelvis anterior tilting on the sagittal plane were significantly improved without a weakening of push-off (p < 0.05). In a group of 8 subjects with a recurvatum knee gait pattern before operation, the postoperative kinematic and kinetic parameters of the knee joint were significantly improved (p < 0.05). In a group of 8 subjects with ipsilateral pelvic external rotation before operation, the postoperative pelvic deviations on the transverse plane were significantly decreased (p < 0.05). These findings suggest that the soft tissue surgery for correcting equinus deformity improves not only the abnormal gait pattern of the ankle, but also that of the knee and pelvis.

Keyword

Cerebral palsy; equinus; soft tissue surgery; gait analysis

MeSH Terms

Male
Kinetics
Joints/physiopathology/surgery
Humans
Hemiplegia/*surgery
Gait/physiology
Female
Equinus Deformity/*surgery
Child, Preschool
Child
Cerebral Palsy/*surgery
Biomechanics
Ankle Joint/physiopathology/surgery
Adolescent

Figure

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  Fig. 1 Postoperative ankle kinematic and kinetic parameters on the sagittal plane in all 16 patients, as compared with preoperative and normal values. (A) ankle flexion (degrees), (B) ankle power generation (watts/kg). Dorsi, Dorsiflexion; Plantar, Plantarflexion; Gen, Generation; Abs, Absorption.

• 

  Fig. 2 Postoperative knee kinematic and kinetic parameters in 8 patients with recurvatum knee gait patterns, as compared with preoperative and normal values. (A) knee flexion (degrees), (B) knee moment (Nm/kg). Flex, Flexion; Ext, Extension.

• 

  Fig. 3 Postoperative pelvic kinematic parameters on the transverse plane in 8 patients with the ipsilateral pelvic external rotation during gait cycle, as compared with preoperative and normal values. Int, Internal rotation; Ext, External rotation.

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