The foot in cerebral palsy

The foot in cerebral palsy is subject to the normal forces applied during walking, but its means of resisting these forces is altered as a result of the muscle weakness and spasticity inherent to this condition. Abnormal muscle activity permits the foot to deform in response to the forces applied to it, as well as causing deformities in their own right. The classical equino-valgus posture adopted by the diplegic foot is principally due to spasticity of the gastrocnemius and weakness of the peroneals. The equino-varus deformity more commonly seen in the hemiplegic foot is associated with spasticity of tibialis posterior While still flexible, the deformities of the cerebral palsy foot may be dealt with by a variety of conservative measures including casting, orthotics and botulinum injection. Once established however, bony surgery is required to correct these deformities. (C) 2002 Published by Elsevier Science Ltd.