Orthopedic Foot and Ankle Surgery for Patients with Cerebral Palsy

Abstract

Foot deformities are common in patients with cerebral palsy (CP), typically resulting from underlying muscle imbalance and contracture. Bracing across the foot and ankle is useful in the setting of dynamic deformity to improve function; however, there is no evidence that bracing is effective at preventing progression to static deformity. Without treatment, spastic foot deformities often lead to long-term pain and loss of mobility, leading to a poor overall quality of life. Multiple factors are considered in the decision to proceed with surgical intervention, including patient age, location of foot deformity, type of deformity, GMFCS level, gait analysis findings, and functional impact. Multiple procedures including tendon lengthening, tendon transfers, osteotomies, and arthrodesis can be performed to reconstitute a plantigrade, braceable foot. This chapter will outline common foot procedures utilized to restore stability and balance for spastic foot deformities in order to guide surgeons in restoring patient function and maintaining a good quality of life.