equinus deformity

..This device will then be used in a prospective clinical study which compares two methods for equinus deformity correction: tendoachilles lengthening (TAL) and gastrocnemius-soleus recession (GSR, "Strayer" procedure)...

..An equinus deformity (limited ankle dorsiflexion range-of-motion [ROM]) is associated with these recurrent ulcers...

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..49, 95% confidence interval = 1.50-8.12). Adverse events were more frequently observed after the use of botulinum toxin type A, but they were considered mild and self-limited...

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..37). There was no significant difference between casting with or without BTX-A, and both improved ROM to a greater degree than BTX-A alone. Casting demonstrated a significantly more robust impact on range of motion than BTX-A alone...

..Btx improves the ability to walk and stand of patients with spastic equinus deformity and hip and knee flexor spasticity...

..Most importantly, reducing the recurrence of spasticity by delayed serial casting may offer the possibility of decreasing the frequency of botulinum toxin reinjections...

..stimulation, as suggested in focal dystonia or in adult spastic patients, 12 children with dynamic foot equinus deformity were randomly assigned to two groups in a blinded, clinically controlled trial...

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..Gait speed for the HCL-V and HCL-W groups was unchanged. The study was the first to directly compare three heel-cord-lengthening surgeries...

..Pedobarometric evaluation can also be useful in quantifying clinical changes after treatment with BTX-A...

..When manipulated and segmented appropriately, and with the development of a simple ordinal index, we found that foot pressure data provided a useful tool in tracking changes in patients with spastic equinus...

..CONCLUSIONS: The findings suggest that Botulinum toxin A may be useful in the management of spastic equinus following traumatic brain injury...

..The static components are treated with bony procedures, including various osteotomies and arthrodesis, incorporating biomechanical principles...

..31 N/kg BW postop; P<0.01). Assessment of the force-length capacity of the triceps surae in candidates for tendo Achilles lengthenings may identify individuals at risk of residual weakness and iatrogenic crouch...

..04). These results support the current clinical understanding of the role of calf "tightness" in equinus gait, including the appropriateness and effectiveness of gastrocnemius recession for children with equinus contracture...

..Rotational osteotomies can improve transverse-plane malalignment. Shorter periods of immobilization and aggressive postoperative gait training and strengthening may optimize improvements in gait...

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...

..CONCLUSIONS: Studies using high quality methods are still needed to support evidence-based decisions regarding the use of AFOs for this population...

..In fact, TR remains a main gait determinant, reducing the vertical COM displacement after equinus gait treatment and influencing the general gait pattern...

..Much of the evidence both for and against differences is weak, and results may be explained by methodological limitations. Future research needs to use adequate sample sizes, long-term follow-ups, and broader and more global measures...

..Possible reasons why functional improvements in gait parameters were not observed are also discussed...

..improvement was performed on twelve ambulatory children with diplegic type of cerebral palsy and dynamic equinus deformity. Dynamic equinus deformities were defined as those who had an equinus at initial contact during preoperative ..

..01), and social function (p = 0.00). GAITRite revealed reductions in speed (p = 0.00) and cadence (p = 0.01). CONCLUSIONS: Feasibility was confirmed. Recommendations include raising minimum age and delaying gait analysis...

..Additionally, assessment of parameters in foot contact patterns, PTIs, and COP path trajectories appears to be helpful in evaluating outcomes after corrective surgery...

..Lengthening of the long toe flexors, in conjuction with tendoachilles lengthening, is an effective means of achieving a balanced foot in cerebral palsy...

..a generalised dynamic neural network (GDNN) was designed to process gait analysis parameters to evaluate equinus deformity in ambulatory children with cerebral palsy...

..501), and stride width (p=0.796), and a significant decrease in CGAS (p<0.001), compared to barefoot condition. CONCLUSIONS: Cerebral palsied children with dynamic equines deformities can benefit from AFOs for ambulation...

..This study assessed the medium term follow-up results of treatment of spastic ankle equinus deformity in cerebral palsy using Hoke or coronal Z-lengthening of the Achilles tendon...

We report a series of percutaneous lengthenings of the Achilles tendon in cerebral palsy children with equinus deformity in 25 patients due to retraction of the triceps surae. This technique has several advantages over open procedures...

..RESULTS: Recurrence of mild degree of equinus deformity was found in 3 out from 66 procedures. No neurological or vascular complications were registered...

Following stroke an equinus deformity of the foot may develop, which may affect the gait pattern of patients differently...

Although equinus deformity in children with cerebral palsy is often corrected with surgery, postsurgical recurrence of the deformity is not uncommon...

..Abnormal muscle activation before the operation can be related to a compensatory response in some patients and this can be manipulated after surgery...

..The technique cannot be recommended for routine clinical use and may only be an alternative for selected cases...

..No deformity of the talus or arthritis of adjacent joints was noted. The Grice procedure gives good long-term results in children with cerebral palsy...

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..The clinical and electrophysiological effects induced by anesthetic blocks may help to guide therapeutic interventions, such as neurotomy, neurolysis or botulinum toxin injection...

..In young children, the possibility of having additional surgeries, including repeat Ilizarov procedures, should be discussed. Even older children should expect additional surgeries to prevent recurrent deformities...

..Whereas tendo-achilles lengthening is efficient and technically undemanding, and one may achieve large amounts of required length, final length is sometimes unpredictable and may markedly decrease posterior muscle group strength...

..LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence...

..A posteromedial incision that begins 2 cm distal to the gastrocnemius indentation and extends proximally will minimize the length of the incision required...

..Pinch callus seems to be as predictive of functional gait alterations as static first metatarsophalangeal joint and ankle dorsiflexion...

..Novel uses for this unique substance will continue to permeate many medical and surgical specialties. Botulinum toxin delivered using more precise techniques may permit improved results without undesired consequences...

BACKGROUND: Bleeding in the calf or ankle joint may lead to ankle equinus deformity, particularly in childhood and during adolescence...

..CONCLUSION: Tibial neurotomy ensures long-term functional improvement of patients with spastic equinus foot. It provides a lasting response for these patients compared with other, more transient treatments...

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..The AHP method was found to be suitable methodology for eliciting subjective opinions and quantitatively comparing treatments in the absence of scientific evidence...

..However, particular care is needed during correction to avoid complications such as anterior subluxation of the talus and joint space narrowing. When complications do occur, intervention should be immediate...

..94 degrees, 95% confidence interval (0.79 degrees, 1.13 degrees). An upper standard deviation of 1.36 degrees is felt to be acceptable for clinical investigation...

..These zones were measured morphometrically and divided into segments which are expressed in percentages of a standard leg length. We maintain that these zones are the injection sites most likely to guarantee the best treatment efficacy...