Recurrence after Achilles tendon lengthening in cerebral palsy

We performed a retrospective review of all hemiplegic and diplegic cerebral palsy (CP) patients who had tendo-Achillis lengthening by open Z-plasty between 1974 and 1985. Fifty-seven patients with 77 heelcord lengthening were followed approximately 10 years. Our postoperative regimen did not routinely include bracing and physiotherapy, but our recurrence rates of 18 and 41% for diplegic and hemiplegic patients, respectively, are comparable to those reported in the literature. Children aged > or = 6 years at initial operation did not have recurrence. Diplegic patients who were operated on before age 4 years or patients who had longitudinal incisions had statistically significantly higher recurrence rates.