cerebral palsy disease is movement dysfunction syndrome, also known as infantile cerebral palsy, cerebral palsy is easy to distinguish the form of behavior mental abnormality, motility disorders, upper limb and lower limb joint deformity and abnormal posture, foot deformity is also a common manifestation of cerebral palsy son, had a foot deformity children, parents also don’t worry, now can medicine developed through the scientific method to correct, treatment first, then foot rehabilitation training, children could walk independently. This process may be long, parents should have enough patience, actively help children recover at an early date. Below small make up to introduce the methods of foot deformity correction under the cerebral palsy children.
a, rehabilitation training method
rehabilitation training divided into active and passive movement, movement to the patients as the main body, while the latter is by parent or Kang Fushi as training.
1, the active movement: if a child has the ability to walk, the healer can make its in a concave two long triangle board walk, can make children with strephenopodia be corrected; Healers control with hole, toys, healers to fix its feet in outreach, spin, children’s weight will inhibit strephenopodia.
2, passive movement: children take the supine position, use the treatment to the patient’s lower limb outreach, outside screw, hold the child at the bottom of the foot forward, to pull away from the calf muscles around joints, and repeatedly activity from the leg joints, to expand the range from the leg joints and the direction of the maximum resistance is the direction of pull. Force is in the process of pressure, prevent a hamstring strain.
2, surgical correction method
1, horseshoe deformity correction:
( 1) Tibial muscle branch of amputation: to cut off the gastrocnemius and soleus muscle or cut off, both for correct spastic water chestnut deformation effectively, still can reduce ankle clonus, helpful to walk also. Preoperative must ascertain ankle clonus is because of the calves or caused by the soleus. As long as knee flexion, such as ankle clonus disappear, expressed as calves, otherwise the result of the soleus. Which can make cut off a piece of tibial muscle branch selection basis.
( 2) Leg triceps release.
spastic horseshoe has two situations:
1) knee unbend have a horseshoe bend your knees at 90 & deg; When the water chestnut can be corrected.
2. Bend your knees or knee horseshoe are not correct. Former explain the reason of the horseshoe is because of the gastrocnemius muscle contracture, correcting method is the starting point of the calf from bottom to the upper tibia femoral; The latter account for the horseshoe is gastrocnemius and soleus contracture. Correct method should be Achilles YanChangShu.
(3) the Achilles tendon check point forward: because of the Achilles tendon extended postoperative, horseshoe deformities often relapse. Remove the Achilles tendon check point to anyone from the trailing edge joints of calcaneal dorsal. So reduce the leverage of leg triceps. The water chestnut has not yet been fixed, curative effect is better.
2, foot varus and valgus deformity correction:
to have fixed and valgus, calcaneal wedge osteotomy or subtalar joint arthrodesis to correct, and increase the stability of the foot. But at the same time, you have to correct the muscle is muscle imbalance. General muscle of the varus deformity is the tibialis anterior muscle and posterior tibial contracture, muscle of the valgus is fibula long and short muscle contracture. The two muscles so be moved to the opposite position to correct deformities.
others advocate pretibial muscle or posterior tibial tendon split into two, half of the tendon is still in the original check point, the other half seam to short peroneal muscle or cuboid up correct varus deformity. Must be determined before the surgery which a muscle plays a main role of deformity, which block is split. Such as simply because of the posterior tibial muscle contracture varus deformity, can be lengthened for Z posterior tibial tendon or posterior tibial tendon or extend the muscle.
3, Yang two-toed feet correct:
this deformity clinically rare. Often due to the Achilles tendon extended excessive or done at the same time cut off caused by postoperative tibial muscle. Can be after the tibialis anterior muscle, muscle and gastrocnemius to the Achilles tendon. Others claim to remove the talus.
3, cerebral palsy sequela to have?
ankle deformity in children with cerebral palsy, the rate is as high as 93%, is one of the most common performance of the patients with pediatric cerebral palsy. Because after the birth of neonatal cerebral palsy patients were able to see the foot deformity, therefore, the cognition of children with cerebral palsy foot performance, better able to find the existence of cerebral palsy. Foot deformity of cerebral palsy children is, there is one side or both sides zubu foot plantar flexion varus deformity. Growth after unilateral deformity, walking with a limp, bilateral deformity, swaying walk.
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