The Foot in Cerebral Palsy

Julieanne P Sees; Freeman Miller

doi:10.1016/j.fcl.2021.07.002

The Foot in Cerebral Palsy

Foot Ankle Clin. 2021 Dec;26(4):639-653. doi: 10.1016/j.fcl.2021.07.002. Epub 2021 Aug 17.

Authors

Julieanne P Sees¹, Freeman Miller²

Affiliations

¹ Department of Orthopedics, Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA 19107, USA.
² Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, BOX 269, Wilmington, DE 19899, USA. Electronic address: fmiller@nemours.org.

PMID: 34752232
DOI: 10.1016/j.fcl.2021.07.002

Abstract

Children with cerebral palsy frequently develop foot deformities, most commonly equinus contractures, which can be managed with orthotics up to age 5 to 7 years. Plantar flexor lengthening, typically around this age, should be restricted to the offending muscle only, usually with a fascia release of the gastrocnemius. Equinovarus, mainly a problem in children with unilateral cerebral palsy, often responds to plantar flexor lengthening. If further tendon transfers are needed, they should be done when the child is older to avoid overcorrection. Planovalgus mostly improves spontaneously up to age 5 years. Surgical correction is best done in adolescence.

Keywords: Cerebral palsy; Equinovarus; Equinus; Natural history; Planovalgus.

Publication types

Review

MeSH terms

Adolescent
Cerebral Palsy* / complications
Child
Child, Preschool
Equinus Deformity* / etiology
Equinus Deformity* / surgery
Foot
Foot Deformities* / etiology
Foot Deformities* / surgery
Humans
Muscle, Skeletal