HEEL CORD ADVANCEMENT IN CHILDREN WITH SPASTIC EQUINUS DEFORMITY

Heel cord advancement has been advocated for treatment of spastic equi nus deformity. Transferring the gastrosoleus anteriorly weakens it by changing the lever arm rather than the resting length. A retrospective review of 90 children with 122 limbs undergoing heel cord advancement revealed 11% excellent, 53% good, and 35% poor results (average follo w-up 9.7 years). The results were statistically better in diplegics an d community walkers. The better results in previous studies may be due to procedure modifications and shorter follow-up. Since we obtain com parable results with simlper heel cord lengthenings, we no longer do h eel cord advancement.