Plâtres successifs d'extension de genou

When children with cerebral palsy are walking with a severe crouch pattern, hamstrings are often involved. They can be shortened by a passive contracture or by spasticity or both. Full extension of the knee is stopped by this tightness during the swing phase and/or in the stance when the foot reaches the ground. Our aim is to carry out sessions of successive plaster casts to extend the knees, according to a protocol involving an initial assessment, plaster casts (after botox injections or without), intensive physiotherapy and a final assessment after therapy. This treatment may allow to delay surgery, or diminish their extent, to regain better joint range stretching (especially knee extension) in case of a beginning of recurrence after surgery, to improve or optimize the support of orthopaedic devices making ambulation easier. Management with successive plaster casts has been done for 20 years, concerning 30 patients and it is obvious that our experience has to be shared. Statistical studies have to be carried out to appreciate the results according to the clinical cases.