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ankle equinus

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https://www.readbyqxmd.com/read/29150297/prolonged-stretching-of-the-ankle-plantarflexors-elicits-muscle-tendon-adaptations-relevant-to-ankle-gait-kinetics-in-children-with-spastic-cerebral-palsy
#1
Teresa Martín Lorenzo, Eduardo Rocon, Ignacio Martínez Caballero, Ana Ramírez Barragán, Sergio Lerma Lara
Tissue related ankle hyper-resistance has been reported to contribute to equinus gait in children with spastic cerebral palsy. Hence, ankle plantarflexor stretching programs have been developed in order to restore passive ankle dorsiflexion. Despite high quality evidence on the limited effects of stretching on passive joint mobility, further muscle-tendon adaptations have been reported which may impact gait performance. As such, children with spastic cerebral palsy subject to long-term manual static stretching achieved dorsiflexion gains through the reduction of muscle and fascicle strain whilst preserving tendon strain, and prolonged use of ankle-foot orthoses achieved similar dorsiflexion gains through increased tendon strain whilst preserving muscle and fascicle strain...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29072044/comparison-of-the-effect-of-focused-and-radial-extracorporeal-shock-waves-on-spastic-equinus-in-patients-with-stroke-a-randomized-controlled-trial
#2
Yah-Ting Wu, Chih-Ning Chang, Yi-Min Chen, Gwo-Chi Hu
BACKGROUND: Recent studies have suggested that either focused or radial shock wave therapy is an effect method for the treatment of spasticity in patients with stroke. However, no previous study compared these two types of extracorporeal shock wave on spasticity in patients with stroke. This study aimed to compare the effect of focused and radial shock wave therapy for the treatment of spastic equinus in patients with stroke. DESIGN: Randomized control trial. SETTING: Outpatient rehabilitation center in a medical center...
October 25, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29025282/clinical-outcomes-following-an-open-gastrocnemius-recession-combined-with-an-endoscopic-plantar-fasciotomy
#3
Jennifer L Mulhern, Nicole M Protzman, N Jake Summers, Stephen A Brigido
At present, there is a paucity of literature describing the clinical outcomes following a combined gastrocnemius recession and endoscopic plantar fasciotomy. The purpose of the present report is to describe our preliminary findings following a combined gastrocnemius recession and endoscopic plantar fasciotomy for the treatment of plantar fasciitis and gastrocnemius equinus recalcitrant to conservative therapy. Twenty-five consecutive ankles in 23 patients (age 51.2 ± 12.5 years, 4 men) met the inclusion and exclusion criteria...
October 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28984769/conservative-treatment-for-equinus-deformity-in-children-with-cerebral-palsy-using-an-adjustable-splint-assisted-ankle-foot-orthosis
#4
Wei Chen, Xiaoyu Liu, Fang Pu, Yang Yang, Lizhen Wang, Hong Liu, Yubo Fan
BACKGROUND: A novel splint, the assisting ankle-foot orthoses (AFO), was developed to provide adjustable sustained stretching to improve conservative treatment for equinus deformities in children with cerebral palsy (CP). The treatment effect was validated by follow-up visits. METHODS: This study involved subjects between 2 and 12 years old, including 28 CP children treated with splint-assisted AFO correction, 30 CP children treated with static AFO correction, and 30 normal children with typical development (TD)...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28953163/the-effect-of-plantar-flexor-lengthening-on-foot-pressure-in-ambulatory-children-with-cerebral-palsy
#5
Oussama Abousamra, Joshua Schwartz, Chris Church, Nancy Lennon, John Henley, Tim Niiler, Freeman Miller
This study aimed to assess the effects of plantar flexor lengthening (PFL) on dynamic foot pressures of children with cerebral palsy using pedobarographs. Of 97 enrolled, 13 children with 18 legs had PFL. Age at surgery was 4.7 (2.8-8.8) years. A significant increase in ankle dorsiflexion and heel impulse was achieved postoperatively and was maintained at 5 years. The coronal plane pressure index increased postoperatively, but reverted to preoperative levels at the 5-year follow-up. Children tend to have more valgus after PFL...
September 25, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28945687/can-repeated-ponseti-management-for-relapsed-clubfeet-produce-the-outcome-comparable-with-the-case-without-relapse-a-clinical-study-in-term-of-gait-analysis
#6
Yu-Bin Liu, Shu-Yun Jiang, Li Zhao, Yan Yu, Da-Hang Zhao
BACKGROUND: The prevention and treatment of relapsed clubfoot remained challenging tasks. There were controversies as to treatment options and management, such as complete subtalar release, application of an Ilizarov external frame, or repeated Ponseti method; and different options were available in different treatment centers. This study was designed to evaluate the clinical outcome of relapsed clubfeet treated by repeated Ponseti method in comparison with the cases without relapse in term of gait analysis and to clarify the clinical efficacy of repeated Ponseti method in treating the relapsed clubfeet...
September 22, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28918357/long-term-follow-up-after-tibialis-anterior-tendon-shortening-in-combination-with-achilles-tendon-lengthening-in-spastic-equinus-in-cerebral-palsy
#7
Michèle Kläusler, Bernhard Maria Speth, Reinald Brunner, Oren Tirosh, Carlo Camathias, Erich Rutz
Using Tibialis Anterior Shortening (TATS) in combination with Achilles Tendon Lengthening (TAL) to treat spastic equinus in children with cerebral palsy (CP) was described in 2011. Short-term results have indicated a good outcome, especially an improvement of the drop foot in swing phase and the correction of equinus in stance phase. The aim of this study was to analyse the results of the long-term follow-up and to determine the relapse rate of TATS and TAL. The kinematics of the sagittal, frontal and transversal planes were measured by using instrumented 3D gait analysis at three defined time points and then described using the Gait Profile Score (GPS) and Movement Analysis Profile (MAP)...
October 2017: Gait & Posture
https://www.readbyqxmd.com/read/28870553/is-spasticity-always-the-same-an-observational-study-comparing-the-features-of-spastic-equinus-foot-in-patients-with-chronic-stroke-and-multiple-sclerosis
#8
Alessandro Picelli, Gabriella Vallies, Elena Chemello, Paola Castellazzi, Annalisa Brugnera, Marialuisa Gandolfi, Alessio Baricich, Carlo Cisari, Andrea Santamato, Leopold Saltuari, Andreas Waldner, Nicola Smania
Spasticity is common in stroke and multiple sclerosis. To treat spasticity we have a wide range of interventions, whose application may depend not only on the severity of spasticity but also on its etiology. Consequently, a better understanding of muscle spasticity in different neurological diseases may inform clinicians as to the more appropriate therapeutic approach. Our aim was to compare the clinical and ultrasonographic features of spastic equinus in patients with chronic stroke and multiple sclerosis...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28861633/efficacy-of-pedobarographic-analysis-to-evaluate-proximal-medial-gastrocnemius-recession-in-patients-with-gastrocnemius-tightness-and-metatarsalgia
#9
Gustavo Vinagre, Matías Alfonso, Sebastián Cruz-Morande, Miguel Hernández, Carlos Villas
PURPOSE: Proximal medial gastrocnemius recession (PMGR) is a surgical procedure performed in patients with gastrocnemius tightness (GT). The purpose of this study is to evaluate the efficacy of pedobarographic analysis on PMGR in patients with GT and metatarsalgia. METHODS: This prospective study included 52 patients diagnosed with GT treated surgically with PMGR and 49 non-operated upon patients (control group). A total of 55 PMGRs (three bilateral) were performed as an isolated or combined procedure in the treatment group...
November 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28842105/early-protected-weightbearing-for-acute-ruptures-of-the-achilles-tendon-do-commonly-used-orthoses-produce-the-required-equinus
#10
Philip Ellison, Andrew Molloy, Lyndon William Mason
Conservative "functional" management of acute Achilles tendon ruptures has become increasingly popular. Critical to this is the use of the walking orthosis, which positions the ankle in equinus to allow for early weightbearing. Our aim was to test whether 2 common orthoses achieved a satisfactory equinus position. A total of 11 sequentially treated Achilles tendon ruptures were assigned to either a fixed angle walking boot with wedges (FAWW) or an adjustable external equinus-corrected brace (EEB). The lateral radiographs of the cast immobilized tendons showed a mean tibiotalar angle (TTA) of 56° (range 54° to 57°) and a mean tibio-first metatarsal angle (1MTA) of 74° (range 62° to 85°)...
September 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28820439/efficacy-and-safety-of-letibotulinum-toxin-a-for-the-treatment-of-dynamic-equinus-foot-deformity-in-children-with-cerebral-palsy-a-randomized-controlled-trial
#11
Hyun Jung Chang, Bo Young Hong, Sang-Jee Lee, Soyoung Lee, Joo Hyun Park, Jeong-Yi Kwon
The objective of this clinical trial was to compare the efficacy and safety of letibotulinum toxin A and onabotulinum toxin A for improving dynamic equinus foot deformity in children with cerebral palsy (CP). In total, 144 children with spastic CP who had dynamic equinus foot deformity were assigned randomly to the Botulax group (injection of letibotulinum toxin A) or the Botox group (injection of onabotulinum toxin A). The Physician's Rating Scale (PRS), ankle plantar flexor spasticity using the Modified Tardieu Scale, the Gross Motor Function Measure (GMFM)-88, and the GMFM-66 were completed before injection and at 6, 12, and 24 weeks after injection...
August 18, 2017: Toxins
https://www.readbyqxmd.com/read/28755924/ankle-tuberculosis-a-case-in-childhood
#12
F E Navarrete, J Gómez-Alessandri, M Tintó, M Sánchez-González, V Vicent
Articular tuberculosis of the ankle joint is a rare presentation of skeletal tuberculosis (10% of cases). This unusual location and the low index of clinical suspicion leads to delays in diagnosis and treatment. Radiographic and analytic studies are unspecific in the first stage. CAT and MRI are useful in diagnosis. Chemotherapy is the mainstay of treatment and surgery is often required to establish the diagnosis and in the treatment. We report a case of ankle tuberculosis in a 22 month-old child. The diagnosis was confirmed by synovial biopsy...
July 26, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28690469/ankle-reconstruction-in-fibular-hemimelia-new-approach
#13
Hany Hefny, ElHussein M Elmoatasem, Mahmoud Mahran, Tamer Fayyad, Mohamed A Elgebeily, Ahmed Mansour, Mamdouh Hefny
BACKGROUND: Fibular hemimelia is a congenital disorder that is characterized by the absence of the fibula that could be either partial or complete. Successful management aims to restore normal weight bearing and normal limb length. The introduction of the Ilizarov method of limb lengthening has provided an attractive alternative to amputation. During lengthening, the tight posterolateral soft-tissue structures, the thick fibrous fibular band, and the shortened Achilles tendon become tighter and transfer a valgus force to the talus and calcaneus, further aggravating the deformity...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28654502/kinematic-gait-changes-following-serial-casting-and-bracing-to-treat-toe-walking-in-a-child-with-autism
#14
Marybeth Barkocy, James Dexter, Colleen Petranovich
PURPOSE: To evaluate the effectiveness of serial casting in a child with autism spectrum disorder (ASD) exhibiting a toe-walking gait pattern with equinus contractures. SUMMARY OF KEY POINTS: Although many children with ASD toe walk, little research on physical therapy interventions exists for this population. Serial casting has been validated for use in idiopathic toe walking to increase passive dorsiflexion and improve gait, but not for toe walking in children with ASD...
July 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/28560116/infrared-thermography-applied-to-lower-limb-muscles-in-elite-soccer-players-with-functional-ankle-equinus-and-non-equinus-condition
#15
David Rodríguez-Sanz, Marta Elena Losa-Iglesias, Daniel López-López, César Calvo-Lobo, Patricia Palomo-López, Ricardo Becerro-de-Bengoa-Vallejo
Gastrocnemius-soleus equinus (GSE) is a foot-ankle complaint in which the extensibility of the gastrocnemius (G) and soleus muscles (triceps surae) and ankle are limited to a dorsiflexion beyond a neutral ankle position. The asymmetric forces of leg muscles and the associated asymmetric loading forces might promote major activation of the triceps surae, tibialis anterior, transverses abdominal and multifidus muscles. Here, we made infrared recordings of 21 sportsmen (elite professional soccer players) before activity and after 30 min of running...
2017: PeerJ
https://www.readbyqxmd.com/read/28512689/long-term-results-of-fibular-achilles-tenodesis-westin-s-tenodesis-for-paralytic-pes-calcaneus-is-hypercorrection-avoidable-a-longitudinal-retrospective-study
#16
Helder Henzo Yamada, Patricia Maria Moraes de Barros Fucs
PURPOSE: The purpose of this study was to review all cases of patients submitted to Westin's tenodesis, who had calcaneus feet secondary to myelomeningocele sequel, in order to evaluate the anatomical change provided by surgery and also to verify, in a long-term follow-up, the inversion of the deformity depending on the patient's age. METHODS: In this longitudinal retrospective study, all medical records of patients with myelomeningocele sequelae submitted to Westin's tenodesis from 1993 to 2013 in a public university hospital were reviewed...
August 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28476398/a-wound-complication-after-percutaneous-achilles-tendon-lengthening-requiring-surgical-excision-a-case-report
#17
Tiffany K Hoh, Rex W Hung, John S Steinberg, Katherine M Raspovic
A percutaneous tendo-Achilles lengthening procedure corrects limited ankle joint equinus by decreasing the pull of the triceps surae complex. The standard technique using 3-incision hemisection described by Hoke is often used in patients with diabetes because of the minimal number of incisions and low risk of wound complications. We describe a patient who underwent percutaneous tendo-Achilles lengthening with a resultant open wound complication requiring staged surgical debridement.
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28369824/medial-gastrocnemius-and-soleus-muscle-tendon-unit-fascicle-and-tendon-interaction-during-walking-in-children-with-cerebral-palsy
#18
Lee Barber, Chris Carty, Luca Modenese, John Walsh, Roslyn Boyd, Glen Lichtwark
AIM: This study investigates the in vivo function of the medial gastrocnemius and soleus muscle-tendon units (MTU), fascicles, and tendons during walking in children with cerebral palsy (CP) and an equinus gait pattern. METHOD: Fourteen children with CP (9 males, 5 females; mean age 10y 6mo, standard deviation [SD] 2y 11mo; GMFCS level I=8, II=6), and 10 typically developing (6 males, 4 females; mean age 10y, SD 2y 1mo) undertook full body 3D gait analysis and simultaneous B-mode ultrasound images of the medial gastrocnemius and soleus fascicles during level walking...
August 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28367689/operative-anatomy-of-the-medial-gastrocnemius-recession-vs-the-proximal-medial-gastrocnemius-recession
#19
Nathan Kaplan, Xavier Fowler, Noorullah Maqsoodi, Benedict DiGiovanni, Irvin Oh
BACKGROUND: Isolated gastrocnemius contracture (IGC) is associated with various foot and ankle pathologies. To address the problem of IGC, a number of gastrocnemius lengthening procedures have been described. Although proximal medial gastrocnemius recession (PMGR) has shown to be an effective operative treatment for IGC, it poses risks to various anatomic structures around the knee joint and requires the patient to be positioned prone. As an alternative, we proposed to release the medial gastrocnemius at the division between the proximal one-third and distal two-thirds of the gastrocnemius muscle to correct equinus contracture, while minimizing risk to other structures...
April 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28259030/a-pilot-investigation-into-the-relationship-between-static-diagnosis-of-ankle-equinus-and-dynamic-ankle-and-foot-dorsiflexion-during-stance-phase-of-gait-time-to-revisit-theory
#20
Alfred Gatt, Stephanie De Giorgio, Nachiappan Chockalingam, Cynthia Formosa
BACKGROUND: Although the clinical assessment of ankle dorsiflexion has traditionally been measured utilising various goniometric means, the validity of this static examination has never been investigated. Since any impairment in ankle flexibility is likely to result in injuries, it is imperative that the correct examination technique is conducted. HYPOTHESIS/PURPOSE: To determine whether a clinical diagnosis of ankle equinus, or limited ankle dorsiflexion, correlates with a decreased dorsiflexion range of movement of the foot and ankle during gait...
March 2017: Foot
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