The influence of botulinum toxin A injections into the calf muscles on genu recurvatum in children with cerebral palsy
Background - With cerebral palsy (CP), an equinus deformity may lead to genu recurvatum. Botulinum toxin A (BtA) injection into the calf muscles is a well-accepted treatment for dynamic equinus deformity. - Questions/purposes - The purpose of this study was to determine whether BtA injections into t...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
6 March 2013
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| In: |
Clinical orthopaedics and related research
Year: 2013, Volume: 471, Issue: 7, Pages: 2327-2332 |
| ISSN: | 1528-1132 |
| DOI: | 10.1007/s11999-013-2897-7 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s11999-013-2897-7 Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/clinorthop/Fulltext/2013/07000/The_Influence_of_Botulinum_Toxin_A_Injections_into.43.aspx 
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| Author Notes: | Matthias C.M. Klotz MD, Sebastian I. Wolf PhD, Daniel Heitzmann MSc, Simone Gantz MSc, Frank Braatz MD, Thomas Dreher MD |
| Summary: | Background - With cerebral palsy (CP), an equinus deformity may lead to genu recurvatum. Botulinum toxin A (BtA) injection into the calf muscles is a well-accepted treatment for dynamic equinus deformity. - Questions/purposes - The purpose of this study was to determine whether BtA injections into the calf muscles to decrease equinus would decrease coexisting genu recurvatum in children with diplegic CP. - Methods - In a retrospective study, 13 children (mean age, 5 years) with spastic diplegic CP showing equinus and coexisting primary genu recurvatum, who were treated with BtA injections into the calf muscles, were included. Evaluations were done before and 6 and 18 weeks after intervention using three-dimensional gait analysis and clinical examinations according to a standardized protocol. Basic statistical analyses (power analysis, ANOVA) were performed to compare genu recurvatum before treatment and at 6 and 18 weeks after injection with BtA. - Results - During stance phase, maximum ankle dorsiflexion was increased substantially from −3.0° ± 14.3° before to 6.2° ± 14.2° 6 weeks after the injections. Despite this, with the numbers available, the amount of recurvatum in stance did not improve with treatment at either 6 or 18 weeks. There was significant improvement of knee hyperextension during stance phase of 6.2° between baseline and 18 weeks after BtA injection, but a genu recurvatum was still present in most patients. - Conclusions - Despite improvement of ankle dorsiflexion after injection with BtA, genu recurvatum did not show relevant improvement at 6 or 18 weeks after injection with the numbers available. Because knee hyperextension remained in most patients, other factors leading to genu recurvatum should be taken into consideration. In addition, a botulinum toxin-induced weakness of the gastrocnemius may explain why recurvatum gait was not significantly reduced. - Level of Evidence - Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. |
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| Item Description: | Gesehen am 19.03.2021 |
| Physical Description: | Online Resource |
| ISSN: | 1528-1132 |
| DOI: | 10.1007/s11999-013-2897-7 |