[Lengthening of the triceps surae muscle in children with motor disorders of cerebral origin performed before the age of 6. Results at the end of growth].
Thirty-seven patients with cerebral palsy aged between two and six years had a lengthening of the triceps by various methods: gastrocnemius recession alone or combined with soleus lengthening (Green), lengthening of the tendon Achilles by the Green method, or by Z-lengthening. All were reviewed at the end of growth. Recurrence was more frequent, in two cases out of four, in those operated on before the age of three years. There were four recurrences out of 10 in those operated on between three and four years and four out of 23 among those between four and six years. There were three cases of talus, only one of which was severe in a child who had not yet walked. There was no other deterioration of function. In six cases operated on before they had begun to walk, two did not achieve walking because of the severity of their motor state. Recurrence was more frequent in hemiplegic than in diplegic children. Operative technique must be precise. Lengthening of the tendon Achilles is preferable to gastrocnemius recession. Plaster casts are kept on for three weeks. Whilst splintage is ultimately unnecessary, it is necessary to re-educate the triceps muscle.
Taussig
G
G
Service de chirurgie orthopédique et rééducation pédiatrique, Institut national de réadaptation, Saint Maurice.
Pilliard
D
D
D002547:Cerebral Palsy / Q000534:rehabilitation / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007866:Leg / Q000601:surgery*; D008124:Locomotion; D008722:Methods; D009132:Muscles / Q000601:surgery*; D012008:Recurrence; D013710:Tendons / Q000601:surgery
L'allongement du triceps sural chez l'enfant infirme moteur d'origine cérébrale réalisé avant l'âge de 6 ans. Résultats en fin de croissance.