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Ready for Gait Optimization Surgery in Cerebral Palsy?
Explore our specialized surgical procedures at Pediatric Orthopedics for optimizing gait in cerebral palsy. We offer comprehensive patient centred treatments for Flatfoot correction, footdrop, intoeing, crouch gait and knee alignment problems in cerebral palsy. Schedule a consultation now to discuss how we can improve your child’s mobility and quality of life. Your child deserves the best pediatric orthopedic care—we’re here to help.
Children with cerebral palsy who have walking ability or potential require careful structured follow-up in the clinic to ensure that their walking is optimized throughout growth. According to Dr. Qureshi, Pediatric Orthopedic Surgeon in Dubai, issues which can impact mobility include muscle tightness and contractures, bony deformity, and joint dislocation.
Dr. Qureshi co-ordinates the care of patients with a multi-disciplinary team approach involving healthcare professionals who share an interest in caring for children with cerebral palsy :
- Pediatric physiotherapy – Important to (i) condition muscles before surgery, (ii) rehabilitate following surgery and (iii) maintain the gains from surgery.
- Pediatric Orthotist – Splintage and bracing as an important cornerstone of helping to correct deformities and works in synch with surgery to optimise outcomes. A skilled orthotist helps the surgeon to achieve the functional aims of treatment by delivering patient spcific solutions for bracing and splintage.
- Pediatric Occupational Therapy – Occupational therapists ensure patient’s interactions with their physical environment are optimised through home adjustments or assistive devices to help with mobility.
- Pediatric Neurology – Accurate characterisation of the exact neurological deficit is invaluable in the treatment of children with cerebral palsy. By working alongside Pediatric Neurologists, Dr. Qureshi ensures that each patient receives a tailor made solution to their mobility needs based on comprehensive assessment of the underlying diagnosis.
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Surgical strategies for gait optimization
Dr. Qureshi generally recommends considering flat foot reconstruction when the foot has completed the majority of its growth, typically during the teenage years. The concern with earlier surgery lies in potential changes in foot shape with growth. Dr. Qureshi often suggests operating on one foot at a time, allowing patients to assess outcomes before proceeding with surgery on the other foot, ensuring reasonable mobility throughout the treatment.
Procedures which may be included in single event multi-level surgery are selected to address the patient’s specific gait problem:
- Hip surgery – Hip subluxation (slippage) can be an issue for mobility so surgery to stabilise the hip may be offered. Tightness in muscles across the hips may need to be addressed with selective muscle releases.
- Rotation osteotomy – Children who walk with their feet turned in may benefit from the rotation of the bone being corrected by surgery.
- Knee surgery – Children who walk with their knees bent (crouch gait) often benefit from surgery to straighten the knees (distal femoral extension osteotomy) and to re-tension the quadriceps muscle on the front of the leg (extensor mechanism distalization).
Case A : 14 year old with crouch gait (bent knees with muscle contractures)
Bent knee walking before surgery and straight knee walking after surgery
- Foot surgery – Dr. Qureshi employs a range of techniques depending on the type of deformity in the foot. Surgery may include osteotomy (bony surgery to change the length or alignment of certain bones), fusion (stabilizing abnormal joints in severe deformities), tendon lengthenings (alleviate tight muscles) and tendon transfers (turn a muscle’s deforming force into a corrective force).
Case B: 17 year old with hemiplegia and right flat foot pointing outwards
