Jacob Mathew1 , Raju Karuppal2 , Sandhya Somasundaran3 , P.D. Sinildas4
BACKGROUND Severe crouch gait in children with spastic diplegia causes excessive loading of the patellofemoral joint and may result in gait deterioration, anterior knee pain, and progressive loss of function. We retrospectively evaluated the effect of singleevent multilevel surgery (SEMLS) on functional mobility at two years with the help of the Gross Motor Function Classification System (GMFCS). METHODS Between the period of 2017 and 2019, 25 children with spastic cerebral diplegia having crouched gait of fewer than 12 years of age underwent SEMLS. The patients were classified according to their GMFCS. The surgical intervention consisted of both soft tissue and bony procedures. Paired-samples t-test was used to compare the values of physical examination findings and walking speed. Two paired sample Wilcoxon signed-rank test was used to compare functional walking scales. RESULTS The study group included 15 male and 10 female patients with a mean age of 10.6 years. A total of 105 soft tissue procedures and 25 bony procedures were performed. Majority achieved the ability to walk 500 m at the end of follow-up. The median for FAQ (Functional Assessment Questionnaire) which was 5 before surgery, improved to 6 at 1 year and 7 at 2 years. CONCLUSIONS SEMLS for older children and adolescents with crouch gait is effective for improving function and independence. Improvements that were noted at one year were maintained at two years and later.
