Stair-shaped Achilles tendon lengthening in continuity - A new method to treat equinus deformity in patients with spastic cerebral palsy. 2019

Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
Department of Foot and Ankle Surgery, The Second Hospital of Shandong University, Shandong University, Jinan 250033, China. Electronic address: lizhengxun750512@126.com.

BACKGROUND Equinus of the ankle is a common deformity in spastic cerebral palsy. Achilles tendon lengthening is one of the effective options for the treatment of equinus deformity. METHODS In the study, a new stair-shaped Achilles tendon lengthening (ATL) procedure that preserves of the tendon continuity was performed in 28 tendons with equinus deformity (20 patients, mean age=10.5±2.6 years). The results were compared with a group of patients treated with the Z-lengthening procedure. During the latest follow-up visit, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot scale score was much higher in the stair-shaped ATL group than in the Z-lengthening group (p<0.05). RESULTS The two groups showed similar surgical correction angle after ATL(37.2±3.5° for stair-shaped ATL and 36.1±4.5° for Z-lengthening). During the latest follow-up visit, the correction angle in the Z-lengthening group decreased to 21.6±4.3°, which was lower than in the stair-shaped ATL group (29.0±3.1°; p<0.05). In addition, the data regarding the time required by each patient before being able to start rehabilitation and walking as well as gaining better stability for running indicated that the stair-shaped ATL group recovered significantly quicker than the Z-lengthening group. CONCLUSIONS The stair-shaped ATL procedure resulted in a successful correction of the equinus deformity in spastic cerebral palsy, with the advantage of preserving a degree of continuity without a complete section of the tendon. This confers greater antigravity stability and quicker recovery in patients.

UI MeSH Term Description Entries
D008297 Male Males
D002547 Cerebral Palsy A heterogeneous group of nonprogressive motor disorders caused by chronic brain injuries that originate in the prenatal period, perinatal period, or first few years of life. The four major subtypes are spastic, athetoid, ataxic, and mixed cerebral palsy, with spastic forms being the most common. The motor disorder may range from difficulties with fine motor control to severe spasticity (see MUSCLE SPASTICITY) in all limbs. Spastic diplegia (Little disease) is the most common subtype, and is characterized by spasticity that is more prominent in the legs than in the arms. Pathologically, this condition may be associated with LEUKOMALACIA, PERIVENTRICULAR. (From Dev Med Child Neurol 1998 Aug;40(8):520-7) Diplegic Infantile Cerebral Palsy,Little Disease,Monoplegic Cerebral Palsy,Quadriplegic Infantile Cerebral Palsy,Spastic Diplegia,CP (Cerebral Palsy),Cerebral Palsy, Athetoid,Cerebral Palsy, Atonic,Cerebral Palsy, Congenital,Cerebral Palsy, Diplegic, Infantile,Cerebral Palsy, Dyskinetic,Cerebral Palsy, Dystonic-Rigid,Cerebral Palsy, Hypotonic,Cerebral Palsy, Mixed,Cerebral Palsy, Monoplegic, Infantile,Cerebral Palsy, Quadriplegic, Infantile,Cerebral Palsy, Rolandic Type,Cerebral Palsy, Spastic,Congenital Cerebral Palsy,Diplegia, Spastic,Infantile Cerebral Palsy, Diplegic,Infantile Cerebral Palsy, Monoplegic,Infantile Cerebral Palsy, Quadriplegic,Little's Disease,Monoplegic Infantile Cerebral Palsy,Rolandic Type Cerebral Palsy,Athetoid Cerebral Palsy,Atonic Cerebral Palsy,Cerebral Palsies, Athetoid,Cerebral Palsies, Dyskinetic,Cerebral Palsies, Dystonic-Rigid,Cerebral Palsies, Monoplegic,Cerebral Palsy, Dystonic Rigid,Cerebral Palsy, Monoplegic,Diplegias, Spastic,Dyskinetic Cerebral Palsy,Dystonic-Rigid Cerebral Palsies,Dystonic-Rigid Cerebral Palsy,Hypotonic Cerebral Palsies,Hypotonic Cerebral Palsy,Mixed Cerebral Palsies,Mixed Cerebral Palsy,Monoplegic Cerebral Palsies,Spastic Cerebral Palsies,Spastic Cerebral Palsy,Spastic Diplegias
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D004863 Equinus Deformity Plantar declination of the foot. Equinus Contracture,Talipes Equinus,Talipes Equinovalgus,Contracture, Equinus,Contractures, Equinus,Deformities, Equinus,Deformity, Equinus,Equinovalgus, Talipes,Equinus Contractures,Equinus Deformities
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000125 Achilles Tendon Tendon that connects the muscles in the back of the calf to the HEEL BONE. Calcaneal Tendon,Tendo Calcaneus,Calcaneal Tendons,Tendon, Achilles,Tendon, Calcaneal,Tendons, Calcaneal
D000843 Ankle Joint The joint that is formed by the inferior articular and malleolar articular surfaces of the TIBIA; the malleolar articular surface of the FIBULA; and the medial malleolar, lateral malleolar, and superior surfaces of the TALUS. Ankle Syndesmosis,Articulatio talocruralis,Distal Tibiofibular Joint,Inferior Tibiofibular Joint,Talocrural Joint,Tibiofibular Ankle Syndesmosis,Tibiofibular Syndesmosis,Ankle Joints,Ankle Syndesmoses,Ankle Syndesmosis, Tibiofibular,Distal Tibiofibular Joints,Inferior Tibiofibular Joints,Joint, Ankle,Joints, Ankle,Syndesmosis, Ankle,Talocrural Joints,Tibiofibular Ankle Syndesmoses,Tibiofibular Joint, Distal,Tibiofibular Syndesmoses
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D016138 Walking An activity in which the body advances at a slow to moderate pace by moving the feet in a coordinated fashion. This includes recreational walking, walking for fitness, and competitive race-walking. Ambulation

Related Publications

Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
January 2013, Journal of pediatric orthopedics. Part B,
Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
February 2011, Gait & posture,
Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
January 1993, Chirurgia narzadow ruchu i ortopedia polska,
Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
June 2015, Journal of pediatric orthopedics,
Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
October 2017, Gait & posture,
Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
January 2015, Ortopedia, traumatologia, rehabilitacja,
Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
January 1969, Acta orthopaedica Scandinavica,
Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
December 2000, Foot & ankle international,
Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
January 2004, Ortopedia, traumatologia, rehabilitacja,
Zhengxun Li, and Ning Zhang, and Yang Wang, and Songhua Cao, and Zheng Huang, and Yong Hu
January 1997, Developmental medicine and child neurology,
Copied contents to your clipboard!