ArticleJournal of orthopaedic case reports2026
Combined Gastrocnemius Release with Gracilis and Toe Flexor Release Offers a Targeted Multi-Level Approach within Single Event Multi-Level Surgery for Correcting Unilateral Lower Limb Deformities in Spastic Hemiplegic Cerebral Palsy.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Spastic hemiplegic cerebral palsy (CP) often causes multi-level lower limb deformities, impairing gait and mobility. Single-level surgeries yield suboptimal results due to persistent spasticity elsewhere. Case Series: We report outcomes in 15 ambulatory patients (aged 4-18 years, gross motor function classification system [GMFCS] I-III) undergoing combined gastrocnemius release, gracilis release, and toe flexor lengthening as part of single-event multi-level surgery (SEMLS) in spastic hemiplegic CP. Results: Ankle dorsiflexion improved from -10° to +10° (P < 0.05), knee flexion reduced from 24° to 6° (P < 0.05), and toe clawing resolved in all. Gait symmetry, step length, and GMFCS levels were enhanced; complications were minimal (overcorrection in 1, weakness in 1). Conclusion: This multi-level soft-tissue release effectively restores biomechanics with low recurrence, supporting SEMLS principles. Gastrocnemius, gracilis, and toe flexor release is a safe and effective SEMLS strategy significantly improving gait, functional mobility, and quality of life. Study Design: Case Series (Level of Evidence: Level IV).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.