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Lever Arm Disorders of the Feet in Cerebral Palsy

Volume 10 | Issue 1 | January-April 2024 | Page: 26-33 | Atul Bhaskar DOI- https://doi.org/10.13107/ijpo.2024.v10i01.175 Submitted: 11/02/2024; Reviewed: 26/02/2024; Accepted: 13/03/2024; Published: 10/04/2024 Authors: Atul Bhaskar MS Ortho, FRCS Ortho, MCH, DNB [1,2,3] [1] Department of Orthopaedics, Apollo Hospital, Mumbai, Maharashtra, India. [2] Department of Orthopaedics, SRCC NH Hospital, Mumbai, Maharashtra, India. [3] Department […]

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 Disorders of the Feet in Cerebral Palsy

Crouch Gait: Evaluation and Management

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Lever Arm Disorders of the Feet in Cerebral Palsy

Volume 10 | Issue 1 | January-April 2024 | Page: 26-33 | Atul Bhaskar

DOI- https://doi.org/10.13107/ijpo.2024.v10i01.175

Submitted: 11/02/2024; Reviewed: 26/02/2024; Accepted: 13/03/2024; Published: 10/04/2024

Authors: Atul Bhaskar MS Ortho, FRCS Ortho, MCH, DNB [1,2,3]

[1] Department of Orthopaedics, Apollo Hospital, Mumbai, Maharashtra, India.
[2] Department of Orthopaedics, SRCC NH Hospital, Mumbai, Maharashtra, India.
[3] Department of Orthopaedics, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Atul Bhaskar,
Paediatric Orthopaedic Surgeon, Department of Orthopaedics, Apollo Hospital, SRCC NH Hospital, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.
E-mail: arb_25@yahoo.com

Abstract

The key for optimum management for progressive musculoskeletal deformities in cerebral palsy patients is understanding the causative mechanisms. The impact of muscle shortening and contracture on the long bones and joints leads to lever arm problems in the foot and ankle and the associated deformities.
Management of each deformity is considered separately although many of these can occur concurrently and the severity my vary in an individual.
Keywords: Lever, Cerebral palsy, Foot & Ankle

References

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How to Cite this Article: Bhaskar A | Lever Arm Disorders of the Feet in Cerebral Palsy | International Journal of Paediatric Orthopaedics | January-April 2024; 10(1): 26-33.
https://doi.org/10.13107/ijpo.2024.v10i01.175

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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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7. Klatt J, Stevens PM. Guided growth for fixed knee flexion deformity. J Pediatr Orthop. 2008;28:626-3
8. Gage JR, Stout JL, Novacheck TF, Matsuo K. Distal femoral extension osteotomy and patellar advancement for crouch in cerebral palsy J Bone Joint Surg Am. 2008, 90:2470-84
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10. Das SP, Pradhan S, Ganesh S, Sahu PK, Mohanty RN, Das SK. Supracondylar femoral extension osteotomy and patellar tendon advancement in the management of persistent crouch gait in cerebral palsy. Indian J Orthop. 2012 Mar;46(2):221-8.
11. Joseph B, Reddy K, Varghese RA, Shah H, Doddabasappa SN. Management of severe crouch gait in children and adolescents with cerebral palsy. J Pediatr Orthop. 2010 Dec;30(8):832-9..
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14. Mohan V, Ganjwala D, Singh K, Shah H. Evaluation of a technique of patellar tendon shortening to correct patella alta associated with severe crouch gait in cerebral palsy. J Pediatr Orthop B. 2023 Jan 1;32(1):87-93.

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

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Lever Arm Disorders of the Feet in Cerebral Palsy

Crouch Gait: Evaluation and Management

Lever Arm Disorders of the Feet in Cerebral Palsy

Crouch Gait: Evaluation and Management

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Lever Arm Disorders of the Feet in Cerebral Palsy

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(Article Text HTML) (Full Text PDF)

Crouch Gait: Evaluation and Management

Abstract

(Article Text HTML) (Full Text PDF)

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