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Crouch Gait: Evaluation and Management

Volume 10 | Issue 1 | January-April 2024 | Page: 20-25 | Hitesh Shah, Dhiren Ganjwala DOI- https://doi.org/10.13107/ijpo.2024.v10i01.174 Submitted: 08/02/2024; Reviewed: 28/02/2024; Accepted: 17/03/2024; Published: 10/04/2024 Authors: Hitesh Shah MS Ortho [1], Dhiren Ganjwala MS Ortho [2] [1] Department of Paediatric Orthopaedics, Kasturba Medical College, Manipal, Manipal academy of higher education, Manipal, Karnataka, [2] Ganjwala […]

Lever Arm dysfunction of Hips in Cerebral Palsy

Volume 10 | Issue 1 | January-April 2024 | Page: 14-19 | Jitendra Kumar Jain DOI- https://doi.org/10.13107/ijpo.2024.v10i01.173 Submitted: 14/01/2024; Reviewed: 10/02/2024; Accepted: 06/03/2024; Published: 10/04/2024 Authors: Jitendra Kumar Jain MS Ortho [1] [1] Trishla Foundation, Tagore Town, Prayagraj, Uttar Pradesh, India. Address of Correspondence Dr. Jitendra Kumar Jain, Chairman, Trishla Foundation, Tagore Town, Prayagraj, Uttar […]

Crouch Gait: Evaluation and Management

Lever Arm dysfunction of Hips in Cerebral Palsy

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Crouch Gait: Evaluation and Management

Volume 10 | Issue 1 | January-April 2024 | Page: 20-25 | Hitesh Shah, Dhiren Ganjwala

DOI- https://doi.org/10.13107/ijpo.2024.v10i01.174

Submitted: 08/02/2024; Reviewed: 28/02/2024; Accepted: 17/03/2024; Published: 10/04/2024

Authors: Hitesh Shah MS Ortho [1], Dhiren Ganjwala MS Ortho [2]

[1] Department of Paediatric Orthopaedics, Kasturba Medical College, Manipal, Manipal academy of higher education, Manipal, Karnataka,
[2] Ganjwala Orthopaedic Hospital, Ahmedabad, Gujarat, India.

Address of Correspondence

Dr. Dhiren Ganjwala,
Ganjwala Orthopaedic Hospital, Ahmedabad, Gujarat, India.
E-mail: ganjwala@gmail.com

Abstract

Crouch gait, a common gait abnormality in spastic diplegia, is characterized by increased knee flexion, ankle dorsiflexion, and reduced hip extension during the stance phase. It occurs due to impairments in anti-gravity muscles and is often aggravated during adolescence due to growth spurts. The condition can result from factors such as lever arm dysfunction, joint deformities, muscle elongation, and weakness. Crouch gait significantly affects mobility, causing early fatigue, patellar tendon elongation, and potential arthritis. Prevention involves strengthening anti-gravity muscles, maintaining proper weight, and using orthoses to correct deformities. Treatment options include surgical interventions like osteotomies, tendon lengthening, and patellar tendon advancement to address deformities and restore function. Non-surgical methods include muscle-strengthening exercises and the use of appropriate orthoses. A comprehensive assessment of modifiable and non-modifiable factors is crucial for tailored management, ultimately improving gait and reducing energy expenditure during walking.
Keywords: Crouch gait, Cerebral palsy, Patella alta, Planovalgus foot, Knee fixed flexion deformity

References

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How to Cite this Article: Shah H, Ganjwala D | Crouch Gait: Evaluation and Management International | Journal of Paediatric Orthopaedics | January-April 2024; 10(1): 20-25 https://doi.org/10.13107/ijpo.2024.v10i01.174

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Lever Arm dysfunction of Hips in Cerebral Palsy

Volume 10 | Issue 1 | January-April 2024 | Page: 14-19 | Jitendra Kumar Jain

DOI- https://doi.org/10.13107/ijpo.2024.v10i01.173

Submitted: 14/01/2024; Reviewed: 10/02/2024; Accepted: 06/03/2024; Published: 10/04/2024

Authors: Jitendra Kumar Jain MS Ortho [1]

[1] Trishla Foundation, Tagore Town, Prayagraj, Uttar Pradesh, India.

Address of Correspondence

Dr. Jitendra Kumar Jain,
Chairman, Trishla Foundation, Tagore Town, Prayagraj, Uttar Pradesh, India.
E-mail: jjain999@gmail.com

Abstract

In cerebral palsy, hip dysfunction is the second most common problem after equines deformity. Abnormal skeletal development of the proximal femur due to abnormal forces in cerebral palsy leads to lever arm function by reducing the length of the lever arm contributing to one of very important causes of gait abnormality. High hip anteversion, high neck shaft angle, subluxation, and dislocation are the most common lever arm dysfunctions at the hip joint. This lever arm dysfunction increases progressively with age and correspondence to GMFCS level. If not identified at a very early stage then it may progress to completely deform the femoral head & hip joint. Early identification and preventive surgery help in preventing progression in GMFCS I to III but can progress despite of preventive surgery in non-walker children FMFCS IV & V. Recurrence of the problem is also very common in non-walker children. So we need detailed information about the lever arm problem in the hip and how to deal with this problem in cerebral palsy children. In this article, we have discussed etiology, and how to identify and management protocols for different lever arm dysfunctions of the hip in cerebral palsy.
Keywords: Cerebral palsy, Lever arm dysfunction of hip, Hip subluxation, Anteversion

References

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How to Cite this Article: Jain J | Lever Arm dysfunction of Hips in Cerebral Palsy | International Journal of Paediatric Orthopaedics | January-April 2024; 10(1): 14-19 . https://doi.org/10.13107/ijpo.2024.v10i01.173

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Half Sized Blog Element (Multi Author Style)

Crouch Gait: Evaluation and Management

Lever Arm dysfunction of Hips in Cerebral Palsy

Crouch Gait: Evaluation and Management

Lever Arm dysfunction of Hips in Cerebral Palsy

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Crouch Gait: Evaluation and Management

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Lever Arm dysfunction of Hips in Cerebral Palsy

Abstract

(Article Text HTML) (Full Text PDF)

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