Toe walking is a very common problem in spastic cerebral palsy. It can be managed by therapy +- botulinum toxin injection along the use of brace (light wt poly propylene articulated AFO) in early age but after certain age (6-7 year) they stop responding to conservative treatment. At this age, they require definite plan of action. Most of the time, they will be advised to go for orthopedic surgery or botulinum toxin along with plaster. On one hand, effect of botulinum toxin lost for only 4-6 month and on other hand traditional orthopedic surgical intervention can lead to reverse deformity like calcaneus gait (over lengthening of tendoachilis ) or recurrence in a very short time . Because of this fact, parents & children both are worried for ideal surgical technique and place of intervention. SEMLOSSS helps a lot in this problem. In this concept we dealt selectively Gastrocnemius (long multiarticular muscle) and leaving antigravity soleus muscle (monoarticular muscle). In most of the children along with Equinus correction we also balance whole limb by correcting all long multiarticular muscle near hip, knee and ankle joint so that children became plantigrade & do not get reversal of deformity .Till now we did not get any recurrence of the deformity .
Posted on: Fri, 30 Aug 2013 06:40:50 +0000