SynthesisSystematic reviews2025
Gastrocsoleus lengthening in combination with tibialis anterior tendon shortening for equinus deformity in children with cerebral palsy: a systematic review.
Synthesis in Systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEquinus is the most common deformity in cerebral palsy, and gastrocsoleus lengthening (GSL) is the most common surgical intervention in children with cerebral palsy (CwCP). GSL is a dose-dependent surgical concept carried out with consideration of the severity of equinus contracture, aimed at addressing this problem during the stance phase of gait. The addition of the novel procedure, tibialis anterior tendon shortening (TATS), may offer benefit in correcting the swing phase problem by addressing foot drop due to the agonist/antagonist relationship with gastrocsoleus. Given the small sample sizes and mixed results presented by current literature, our study aimed to collate the available evidence in order to review the effectiveness and safety of the addition of TATS to the GSL procedure for CwCP with equinus deformity.
methodsIn this PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses)-compliant systematic review, a systematic search of Medline, Embase, Web of Science, and Google Scholar retrieved 674 articles for title and abstract screening. Five original publications were included in the final review. The methodological index for non-randomised studies (MINORS) was used to critically appraise included studies.
resultsSample sizes ranged from 20 to 29, with a mean age at surgery ranging from 10.0 to 16.8 years. All participants underwent pre- and post-operative 3D gait analysis. Variations regarding the technique of the procedure included the suture material used to complete TATS and the anatomical level/zone of GSL. Studies found that combined GSL in combination with TATS demonstrated an improvement in gait profile score (GPS), Gait Variable Score (GVS) at the ankle, and reduced ankle-foot orthosis (AFO) use. No long-term complications were detected because of adding TATS to GSL.
conclusionThe GSL in combined with the TATS procedure appears to be a safe procedure with a low complication rate, which may offer improvements in GPS, GVS, and reduced AFO use; however, comparative studies will assist in identifying the effect this has beyond GSL only and the patients for whom this procedure will provide the best outcomes. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework ( https://osf.io/dp7ha/ ).
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