Although equinus gait is the most common abnormality in children with spastic cerebral palsy (CP) there is no consistency in recommendations for treatment, and evidence for best practice is lacking. The Baumann procedure allows selective fractional lengthening of the gastrocnemii and soleus muscles but the long-term outcome is not known. We followed a group of 18 children (21 limbs) with diplegic CP for ten years using three-dimensional instrumented gait analysis. The kinematic parameters of the ankle joint improved significantly following this procedure and were maintained until the end of follow-up. We observed a normalisation of the timing of the key kinematic and kinetic parameters, and an increase in the maximum generation of power of the ankle. There was a low rate of overcorrection (9.5%, n = 2), and a rate of recurrent equinus similar to that found with other techniques (23.8%, n = 5).
As the procedure does not impair the muscle architecture, and allows for selective correction of the contracted gastrocnemii and soleus, it may be recommended as the preferred method for correction of a mild fixed equinus deformity.
M. Svehlík is a recipient of an APART-fellowship of the Austrian Academy of Sciences at the Division of Peadiatric Orthopaedics, Department of Paediatric Surgery, Medical University of Graz, Austria.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- Received November 18, 2011.
- Accepted April 13, 2012.
- ©2012 British Editorial Society of Bone and Joint Surgery