Comparison of three heel cord surgeries in children with cerebral palsy.
This nonrandomized prospective descriptive study compared outcomes of three isolated heel cord surgeries in children with spastic diplegia cerebral palsy (CP): (1) heel cord advancement (HCA), (2) heel cord lengthening according to Vulpius (HCL-V), and (3) heel cord lengthening according to White (HCL-W). Thirty-two children were tested prior to and approximately 1 year after undergoing one of the three surgeries. Objective measures were collected for ankle passive and active range of motion, gross motor function measure (GMFM), and gait. All surgeries indicated significant improvements in end range passive and active ankle dorsiflexion, GMFM, and dorsiflexion during gait. Gait speed was significantly improved for the HCA group, but appeared to be the result of maturity. 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.
Human Performance Lab, Dept. of Neurological Surgery, Washington Univ., School of Medicine, St Louis, MO 63110, USA.
Jack R
JR
Engsberg
Donna J
DJ
Oeffinger
Sandy A
SA
Ross
Hank D
HD
White
Chester M
CM
Tylkowski
Perry L
PL
Schoenecker
D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004863:Equinus Deformity / Q000601:surgery*; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000601:surgery*; D006365:Heel / Q000601:surgery*; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000601:surgery; D011446:Prospective Studies; D016896:Treatment Outcome