Long Term Follow-up of Subcutaneous Achilles Tendon Lengthening in the Treatment of Spastic Equinus Foot in Patients with Cerebral Palsy.

BACKGROUND Spastic equinus foot is among the most common deformities in patients with cerebral palsy. The optimal therapy of this condition is yet to be determined. Despite a considerable volume of literature concerned with the subject of cerebral palsy, there is still a need for studies focusing on long-term follow-up after corrective procedures. The study aimed to evaluate the long-term effects of subcutaneous Achilles tendon lengthening in the treatment of spastic equinus foot. MATERIAL AND METHODS A total of 100 patients after Hooke's or White's isolated subcutaneous lengthening of the Achilles tendon were invited to participate in the retrospective assessment. Of the above number, 53 patients reported for an examination (76 feet). The average follow-up time was 10.09 years. To enable a more accurate determination of the risk of recurrence, the patients were divided into two groups according to whether they had been operated before or after reaching the age of 8 years. All patients were able to walk and suffered from the spastic type of cerebral palsy. RESULTS The average age of patients at the time of the Achilles tendon lengthening procedure was 7 years. The follow-up time ranged from 3 to 17 years (an average of 10.09 years). The degree of equinus foot contracture before the surgery was from -5 to -60 degrees (an average of -17.53 degrees). Recurrence of the deformity was reported in 43.42% of the patients. Recurrences were more common in those with hemiplegic cerebral palsy. CONCLUSIONS 1. Subcutaneous Achilles tendon lengthening is not associated with a risk of serious complications, while providing good long-term therapeutic outcomes as well as very good cosmetic and functional effects. 2. Subcutaneous Achilles tendon lengthening minimises the costs and time of patients' hospitalisation and uses a relatively simple operative technique.