Gait Analysis of Kinematic Changes After Vulpius Gastrocnemius Recession in Children With Spastic Hemiplegic Cerebral Palsy and Equinus Deformity

Background: Equinus deformity is a common gait abnormality in children with spastic hemiplegic cerebral palsy, resulting in altered ankle kinematics and impaired gait mechanics. Surgical lengthening of the gastrocnemius-Achilles complex aims to restore ankle dorsiflexion and improve functional ambulation. Methods: A retrospective observational study was conducted, including pediatric patients with spastic hemiplegia and equinus deformity treated with Vulpius gastrocnemius recession. Three-dimensional gait analysis was performed preoperatively and six months postoperatively. Kinematic parameters were compared using the Wilcoxon signed-rank test. Results: Twenty-four patients were included. Significant improvements were observed in ankle dorsiflexion at initial contact and during the swing phase, allowing restoration of heel strike and improved foot clearance. Weight-bearing distribution increased from 30% to 49%. Knee kinematics showed partial improvement. Recurrence of equinus deformity occurred in four patients. Conclusions: Vulpius gastrocnemius recession improves ankle kinematics and gait mechanics in children with spastic hemiplegic cerebral palsy, supporting its role as an effective surgical option for equinus deformity.