Calf muscle-tendon lengths before and after Tendo-Achilles lengthenings and gastrocnemius lengthenings for equinus in cerebral palsy and idiopathic toe walking

Abstract The calf muscle-tendon lengths in children exhibiting equinus gait in two clinical populations, cerebral palsy (CP) and idiopathic toe walking (ITW), were examined to compare the effects of diagnosis and two different surgical procedures, Tendo-Achilles lengthening (TAL) versus Vulpius proc...

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Bibliographic Details
Published in:Gait & posture 2009-06, Vol.29 (4), p.612-617
Main Authors: Jahn, Jessica, Vasavada, Anita N, McMulkin, Mark L
Format: Article
Language:English
Subjects:
Achilles Tendon - physiopathology
Achilles Tendon - surgery
Adolescent
Analysis of Variance
Biomechanical Phenomena
Case-Control Studies
Cerebral palsy
Cerebral Palsy - physiopathology
Child
Child, Preschool
Equinus Deformity - physiopathology
Equinus Deformity - surgery
Female
Gait Disorders, Neurologic - physiopathology
Gastrocnemius recession
Humans
Idiopathic toe walking
Male
Muscle, Skeletal - physiopathology
Muscle, Skeletal - surgery
Muscle-tendon lengths
Orthopedics
Retrospective Studies
Tendo-Achilles lengthening
Treatment Outcome
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Summary:Abstract The calf muscle-tendon lengths in children exhibiting equinus gait in two clinical populations, cerebral palsy (CP) and idiopathic toe walking (ITW), were examined to compare the effects of diagnosis and two different surgical procedures, Tendo-Achilles lengthening (TAL) versus Vulpius procedure (VP) gastrocnemius recession. Pre- and post-surgical gait data were obtained from 38 subjects (58 limbs) and 38 age-matched controls. Peak muscle-tendon lengths increased following surgery in 84% of limbs. For medial gastrocnemius (MGAS) and lateral gastrocnemius (LGAS) in stance, muscle-tendon lengths increased significantly following TAL surgeries but were not significantly different pre- and post-VP surgeries. For soleus (SOL) (swing and stance) and MGAS and LGAS (swing), muscle-tendon lengths increased significantly following both TAL and VP surgeries. Pre-operatively, muscle-tendon lengths were significantly shorter for the TAL group compared to the VP group; however, post-operatively the lengths were not significantly different between the surgeries. There were no significant differences between CP and ITW patients or indications that the surgery affected the groups differently. The change in length following surgery was well correlated to the subjects’ initial muscle-tendon length.
ISSN:0966-6362
1879-2219
DOI:10.1016/j.gaitpost.2009.01.001