In cerebral palsy with calcaneus gait, which procedure targets the gastrocnemius-soleus complex?

In cerebral palsy with calcaneus gait, which procedure targets the gastrocnemius-soleus complex?

• A. Lengthening of the gastrocnemius-soleus complex
• B. Tightening of the gastrocnemius-soleus complex
• C. Arthrodesis of the ankle
• D. Tenodesis of the peroneal tendons

Answer: (A)

In cerebral palsy, calcaneus (equinus) gait often comes from a tight gastrocnemius-soleus complex that keeps the ankle in plantarflexion and limits dorsiflexion during the stance phase. Lengthening this muscle-tendon unit reduces the spastic pull, increases passive and functional ankle dorsiflexion, and allows a more normal heel strike and gait pattern. That’s why the procedure that directly addresses this issue is lengthening of the gastrocnemius-soleus complex. Tightening would worsen the problem, ankle fusion would eliminate motion and is a last-resort option, and tenodesis of the peroneal tendons targets lateral stability rather than correcting the plantarflexion contracture.

In cerebral palsy, calcaneus (equinus) gait often comes from a tight gastrocnemius-soleus complex that keeps the ankle in plantarflexion and limits dorsiflexion during the stance phase. Lengthening this muscle-tendon unit reduces the spastic pull, increases passive and functional ankle dorsiflexion, and allows a more normal heel strike and gait pattern. That’s why the procedure that directly addresses this issue is lengthening of the gastrocnemius-soleus complex. Tightening would worsen the problem, ankle fusion would eliminate motion and is a last-resort option, and tenodesis of the peroneal tendons targets lateral stability rather than correcting the plantarflexion contracture.