image based Q.9- A child with abnormal gait

Q. The parents of a child with CP (cerebral palsy)complain of abnormal gait of their child. All of the following  may be steps in surgery for its correction except

1. release Adductor longus

2. release Adductor brevis

3. release Gracilis

4. procedure done bilaterally

Answer -

The abnormal gait in the picture appears to be scissoring gait. It is due to adductor tightness and surgery involves adductor tenotomy.

The adductor brevis is partially removed. Anterior half is usually released as full release might injure obturator nerve branches over it.

Adductor longus is released and gracilis released in severe cases  and

 procedure is done bilaterally to avoid ‘windswept pelvis’