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Percutaneous elongation of the Achilles tendon in children with cerebral palsy
1Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong.
Insights
Percutaneous Achilles tendon elongation improved walking in 89% of children with cerebral palsy. This minimally invasive procedure offered significant functional gains for young patients with spasticity.
Area of Science:
- Orthopedic Surgery
- Pediatric Rehabilitation
- Neuromuscular Disorders
Background:
- Cerebral palsy often involves lower limb spasticity, impacting gait.
- Achilles tendon contractures are common in children with cerebral palsy, leading to ambulatory dysfunction.
Purpose of the Study:
- To evaluate the efficacy of percutaneous Achilles tendon elongation in children with cerebral palsy.
- To assess functional improvements in walking following the procedure.
Main Methods:
- A cohort of 45 children (71 ankles) with cerebral palsy underwent percutaneous Achilles tendon elongation.
- A three-step cut technique was employed, followed by immobilization in a long leg cast.
- Immediate weight-bearing was permitted post-operatively.
Main Results:
- Follow-up ranged from 2 to 5 years.
- Satisfactory outcomes were achieved in the majority of cases.
- Significant improvement in walking ability was observed in 89% of the treated ankles.
Conclusions:
- Percutaneous Achilles tendon elongation is an effective surgical option for managing equinus gait in pediatric cerebral palsy.
- The procedure leads to substantial functional gains in ambulation for affected children.
Abstract:
From 1987 to 1990, 45 children with cerebral palsy underwent percutaneous elongation of the Achilles tendon (71 ankles); the mean age was 5.7 years. Most suffered from spastic diplegia or hemiplegia. A three-step cut technique was used, the limb immobilised in a long leg fiberglass cast and immediate weightbearing allowed. Follow up was from 2 to 5 years. Satisfactory results were obtained with significant improvement in walking in 89%.
