What is Cerebral Palsy?
Cerebral palsy (CP) is a group of disorders affecting movement and muscle tone, often due to early brain development issues.
What is Crouch Gait and why does it Arise in Adolescence?
In adolescents with CP, crouch gait—a walking pattern characterized by excessive bending of the hips, knees, and ankles—can develop. This gait emerges as muscle tightness and joint deformities progress over time. Also rapid increase in height and body weight during adolescence contributes to the development of crouch gait in cerebral palsy.
Figure 1: Crouch gait in cerebral palsy is characterised by excess dorsiflexion of the ankle, flexion of the knee and flexion of the hip. This posture puts a lot of pressure on the knee joint and results in high energy expenditure during walking.
What is Crouch Gait Energy-Inefficient?
Crouch gait is energy-inefficient because the bent posture requires more muscle effort, leading to fatigue and difficulty in walking.
What surgery is performed to correct Crouch Gait?
To correct crouch gait, surgical procedures like distal femur extension osteotomy and patellar tendon shortening are considered. The distal femur extension osteotomy involves cutting and realigning the thigh bone to straighten the knee, while patellar tendon shortening adjusts the tendon below the kneecap to improve its strength and function. These surgeries aim to correct knee alignment, enhance walking ability, and reduce energy expenditure.
Figure 2: X-ray of child in Figure 1 after undergoing Distal Femur Extension Osteotomy (DFEO) and Patella Tendon Shortening (PTS)
What is the post-operative rehabilitation and recovery period after surgery for crouch gait?
Post-operative rehabilitation is crucial and includes physical therapy to strengthen muscles and improve mobility. Recovery varies but typically spans several months, with gradual improvements in walking patterns.
What are the outcomes of surgery for crouch gait?
Expected outcomes of surgery for crouch gait are improved knee extension, more efficient walking, and enhanced overall mobility, contributing to a better quality of life.
Figure 3: Child in Figure 1 one year after surgery showing correction of crouch gait
_ By Dr Sandeep Vaidya, Paedictric Orthopaedic Surgeon, Pinnacle Orthocentre Hospital. For more information, mail drsvvaidya@gmail.com/ call 7028859555.
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