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Ankle Dorsiflexion Improves After Plantar Flexor Surgery

Post-op improvement in peak, mean dorsiflexion in swing phase for children with cerebral palsy

THURSDAY, Dec. 15 (HealthDay News) -- For children with cerebral palsy, ankle plantar flexor lengthening surgery results in significantly improved passive ankle motion, strength, selective motor control, and improved dorsiflexion during the swing phase, according to a study published online Dec. 7 in The Journal of Bone & Joint Surgery.

Jon R. Davis, M.D., from the Shriners Hospitals for Children in Greenville, S.C., and colleagues used quantitative gait analysis to estimate the prevalence of ankle dorsiflexor muscles (antagonist) dysfunction during the swing phase of the gait cycle, and assessed the effect of surgical lengthening of the ankle plantar flexor muscles (agonists) on this function. Gait analysis was performed before and after surgical lengthening of the gastrocnemius-soleus muscle group in 53 children with cerebral palsy (mean age at initial gait analysis: 8 years, 11 months). Data for the analysis were collected from the physical examination, gait study kinematics, and dynamic electromyography in the swing phase.

The investigators found that following ankle plantar flexor lengthening surgery, there were significant improvements in the ankle dorsiflexion passive range of motion, strength and selective control of the ankle dorsiflexor, and peak and mean dorsiflexion in the swing phase. Active ankle dorsiflexor function in the swing phase was present in 79 and 96 percent of the extremities before and after surgery, respectively, with 10 extremities graduating from absent to present.

"The kinematic data support the clinical impression that ankle dorsiflexion during swing phase is improved following ankle plantar flexor lengthening surgery in children with cerebral palsy," the authors write.

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