EQUINUS DEFORMITY CORRECTION IN CEREBRAL PALSY-BAKER'S PROCEDURE A BOON

Abstract

INTRODUCTION Equinus deformity of the ankle is one of the most common problems encountered in cerebral palsy. When conservative measures are clinically ineffective, surgical intervention is indicated. The goal of the treatment of ankle equinus is to obtain a plantigrade foot without  compromising triceps surae function. We present a case of equinus contracture for which gastrocnemius aponeurotic lengthening was done using Bakers procedure. CASE    REPORT 14 year old boy , a known case of cerebral palsy with equinus deformity of left foot. On evaluation Silfverskiold test was positive. B.akers procedure was done. At three months follow up patients was walking with plantigrade foot. DISCUSSION Bakers procedure is tongue in groove  recession of gastrocnemius aponeurosis. Aponeurotic  lengthening is more stable than tendon lengthening. Isolated gastrocnemius lengthening prevents muscle weakness,   overlengthening, crouch gait and decreased recurrence of deformity. CONCLUSION Bakers procedure with a decreased risk of weakening of calf muscles, lower rate of                        overlengthening and lower rate of recurrence is a safer            alternative for equinus deformity correction in cerebral palsy.