Postural impositions on the foot and ankle from trunk, pelvis, hip, and knee in cerebral palsy

Postural impositions on the foot and ankle in cerebral palsied patients may be due to neurological or biomechanical causes. Neurological etiology is related to retained neonatal automatisms, mass reflexes, lack of phasic muscle activity, and lack of voluntary control. Biomechanical impositions on the foot and ankle of superincumbent deformities in the transverse, sagittal, and coronal planes are analyzed and specific examples are cited. It is important to be able to differentiate those problems of the foot and ankle which are primary from those imposed by superincumbent structures. Some iatrogenic problems may be prevented by careful analysis.