Gastrocnemius-Muscle Recession (Silfverskiold Operation) for Spastic Equinus Deformity in Cerebral Palsy

Abstract

Spastic equinus contracture is the most common deformity of the lower extremity in cerebral palsied children. In 1924, Silfverskiold divided spastic equinus contracture into two groups, one of which is passively correctable by flexion of the knee to a right angle. The gastrocnemius function is the primary deforming factor in this group and is the most frequently encountered in children. The Silfverskiold operation, consisting in gastrocnemius-muscle recession with partial neurectomy, is an effective and reliable procedure for spastic equinus deformity when the proper indications are present. One hundred and ten gastrocnenmius-recession operations were performed by the authors between 1947 and 1958 with five failures (recurrence of equinus deformity).