PEDIATRICS Vol. 45 No. 1 January 1970, pp. 116-118
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The Clapper-Dapper

David W. Macfarlane M.D.1 and Susan B. Hanks B.S., RPT1

1 Department of Pediatrics and Crippled Children's Division University of Oregon Medical School Portland, Oregon 97201

One of the problems frequently encountered with ambulatory spastic cerebral palsied children is their tendency to toe walk, due to tightness of the plantar flexors of the ankle. They often develop equinus deformities and, if asymmetrically affected, will bear as little weight as possible on the more involved leg.

Traditional modes of therapy used to counteract deformities have included passive stretching, braces, and surgery

Recently, we examined a child with moderately severe spastic quadriplegia for whom braces had been prescribed and surgery planned for heel-cord lengthening. This child resisted bracing with such vigor that his parents discontinued therapy.

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