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The Vulpius procedure for correction of equinus deformity in patients with hemiplegia

Department of Orthopaedic Surgery, Kumamoto Kinou Hospital, Yamaruro 6-8-1, Kumamoto City 860, Japan.

Correspondence should be sent to Dr A. Shrestha.

Spasm or contracture of gastrocnemius causes an equinus deformity of the ankle in both cerebral palsy and hemiplegia. Its release is therefore required in the treatment of those patients who do not respond to conservative measures. The Vulpius procedure is a simple and effective method for the release of gastrocnemius and is particularly indicated when long periods of immobilisation of the foot and ankle are not desirable. We have used this procedure with good results to correct an equinus deformity in 230 adults with a cerebrovascular accident and various associated medical conditions. It is not only effective in cerebral palsy, but should be considered at an early stage in all adult patients with deformity of the ankle and foot in whom spasm of gastrocnemius is the major cause.