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  • Q&A with Australian Health Practitioners

    My 15 y.o.Son with Left Hemiplegia Cerebral Palsy needs more surgery

    My son has had Orthopedic surgery to lengthen the Achilles tendon in his left leg but after three years his foot/ankle has returned to it's original position of him walking up on his toes. I am not sure who to contact in regards to seeking help with this as we have moved away from the area that we lived when he had the surgery. My question is, what type of specialist should I contact? I was told a Paediactric Neurologist. Is this correct? Thank you
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    Dr Simon Zilko

    Orthopaedic Surgeon

    Dr Simon Zilko - Foot & Ankle Orthopaedic Surgeon Dr Simon Zilko is a locally and internationally trained consultant orthopaedic surgeon who specialises in all … View Profile

    If your son's ankle has now returned to a position of fixed equinus (ie foot pointing down), then there are a couple of options. A paediatric neurologist is a good suggestion, and they may be able to facilitate botox injections to relax the tight calf muscles, combined with serial casting of the leg with plaster/fibreglass to slowly bring the foot back up whilst stretching out the posterior muscles/tendons.

    If serial casting fails, then he may require further surgery. This might involve lengthening of his gastrocnemius in isolation or his Achilles tendon, plus potentially the other posteromedial structures (tibialis posterior, FDL and FHL) - it all depends on what is tight. You would be best to see a foot and ankle specialist orthopaedic surgeon for this.

    After a correction back to neutral is achieved (either non-operatively or with surgery), he will probably need to wear an ankle foot orthosis (AFO) in order to keep his ankle in a good position and prevent recurrence.

    Talk to your GP to start the referral process in your new local area. Best of luck.

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