title: The transverse Vulpius gastrocsoleus recession for equinus gait in children with cerebral palsy.
abstract: We report the results of Vulpius transverse gastrocsoleus recession for equinus gait in 26 children with cerebral palsy (CP), using the Gait Profile Score (GPS), Gait Variable Scores (GVS) and movement analysis profile. All children had an equinus deformity on physical examination and equinus gait on three-dimensional gait analysis prior to surgery. The pre-operative and post-operative GPS and GVS were statistically analysed. There were 20 boys and 6 girls in the study cohort with a mean age at surgery of 9.2 years (5.1 to 17.7) and 11.5 years (7.3 to 20.8) at follow-up. Of the 26 children, 14 had spastic diplegia and 12 spastic hemiplegia. Gait function improved for the cohort, confirmed by a decrease in mean GPS from 13.4° pre-operatively to 9.0° final review (p < 0.001). The change was 2.8 times the minimal clinically important difference (MCID). Thus the improvements in gait were both clinically and statistically significant. The transverse gastrocsoleus recession described by Vulpius is an effective procedure for equinus gait in selected children with CP, when there is a fixed contracture of the gastrocnemius and soleus muscles.
authors.affiliation: The University of Melbourne, Flemington Road, Parkville, Victoria 3052, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Tinney
authors.affiliation: The Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Thomason
authors.affiliation: The Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Sangeux
authors.affiliation: Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Khot
authors.affiliation: Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.
authors.forename: H K
authors.initials: HK
authors.lastname: Graham
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000209:etiology / Q000601:surgery; D004863:Equinus Deformity / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Gait Profile Score; Vulpius; cerebral palsy; gastrocsoleus; kinematics; recession