Diagnosis and treatment of crouch gait in children with cerebral palsy. Report from the 4th Edition of the Transatlantic Orthopedic Surgery Webinar 2022
Bibliographic record
Abstract
Introduction. The fourth edition of the Transatlantic Orthopedic Surgery Webinar 2022 took place on December 12th, 2022. The main theme of the webinar was the treatment of crouch gait in children with cerebral palsy (CP). Speakers from Australia, Canada, China, Germany, India, Poland, Spain, Sweden, Turkey, the United Kingdom, and the United States participated. Results. The first general session presented the biomechanics of crouch gait, the function of the hip and knee muscles in children with CP, the principles of prevention and treatment of crouch gait in spastic diplegia, and the natural course and treatment outcomes of CP in adults. The surgical sessions comprehensively presented the surgical techniques for treating crouch gait: percutaneous myofasciotomy in the posterior knee joint, straightening osteotomy of the distal femur in hemiplegia, asymmetric and symmetric diplegia, techniques for shortening and plastically reconstructing the patellar ligament, anterior hemiepiphysiodesis of the distal femur, and transfer of the hamstring muscles to the rectus femoris muscle. The second general session presented postoperative standing and walking rehabilitation protocols and evaluation of treatment outcomes (pain, fatigue, ambulatory activity, motor function, and quality of life). Summary. The most important conclusions from the event were: do not lengthen the Achilles tendon in zone III in crouch gait; laboratory gait analysis is necessary before lengthening the hamstring muscles; hemiepiphysiodesis of the distal femur can be performed when the predicted growth period is less than two years; distal femur osteotomy should be considered during adolescence for knee flexion contracture of 10-40 degrees; treatment possibilities of tendon transfers and myofasciotomies should be remembered, especially in younger patients. The webinar attracted an audience of approximately 1,600 people from 672 centers located in 57 countries. Most participants came from Poland, the United Kingdom, the United States, Norway, Sweden, and India.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".