Pediatric Orthopedic Surgeons treating a Broken Wrist

SCISSOR GAIT

The manner in which a child with cerebral palsy walks is often that of a Scissor Gait.  The walking is characteristic of how a marionette walks.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Scissor Gait

The effects of cerebral palsy (CP) can often be seen in how children learn to walk, as gait can be significantly altered or impaired as a result of this disorder. The development of the scissor gait identifies one of the movement problems that may occur from cerebral palsy. Mobility may become difficult, painful, and uncharacteristically sluggish when walking in this manner. The scissor gait appears as a type of abnormal gait that frequently occurs when a child has spastic cerebral palsy. The cause of the gait occurs when an upper motor neuron lesion links to the disorder. This walking style can remind parents of a puppet walking or moving. In addition, hypertonia causes the legs, hips, and pelvis to flex to varying degrees, giving the appearance of crouching.

Tight adductor muscles cause irregular walking, which causes the knees and thighs to cross in a scissors-like motion, while the opposing muscles, the abductors, become weak from lack of use. Unless the plantar flexor muscles become freed via an orthopedic surgical treatment, the child will continue to walk on tiptoes.

No matter how mild or severe the spastic CP condition appears, these symptoms, always occur in some way or to some extent.

Symptoms

  • Excessive swinging leg adduction and stiffness.
  • The ankle bends in a plantar fashion.
  • Flexed knees.
  • Internal hip rotation and adduction.
  • Constricted assisting motions of the upper limbs during walking due to increasing contractures of all spastic muscles.

Ineffective management of the scissor gait may provide the following risks:

  1. Growth restrictions or developmental defects as a result of unequal muscular pull
  2. Poor balance and occasional falling.
  3. Pressure sores develop as a result of the frequent rubbing of the knees.
  4. Restricted motion because of stiff joints.
  5. Discomfort brought by persistent muscular tension and joint stress.
  6. Loss of mobility when walking

Treatments for Scissoring Gait

Our doctors believe that early intervention will significantly improve walking and prevent the development of a scissor gait in cerebral palsy children. A two-step program will fix a scissor gate. The first priority will get the muscles to easily contract and relax — spasticity must first be reduced. The second step will get the child to regularly work on improving their walking form through home exercises and physical therapy. Some treatments may work better than others for your child’s spasticity, depending on the severity. Determine the most efficient and advantageous course of treatment by speaking with your child’s physician or physical therapist.

Medications

For short spasticity alleviation, muscle relaxants like baclofen can help decrease muscular hyperactivity. Typically, muscle relaxants administered orally, taken several times daily, only temporarily relieve spasticity. Muscle relaxants can influence the entire body and might make your child feel drowsy, worn out, or weak. For people who simply have spasticity in their legs, this might not be the best option. Another option is an intrathecal pump that becomes surgically installed and can also be used to give medicine to reduce the problem. The danger of adverse effects is decreased since the muscle relaxant in the pump may be administered in lesser dosages because it is directly delivered to the spinal cord.

Surgery

Kids with cerebral palsy who have various operations may experience less spasticity. Surgery in our practice becomes the last option after all other strategies fail or there is no alternative. For example, adductor lengthening surgery may be advised for children who walk with a scissoring gait as there is no alternative. The muscles in the inner thighs need to be lengthened. A selected dorsal rhizotomy procedure can lessen spasticity. By severing the hyperactive nerve fibers, a surgeon can stop and prevent muscle contractions. The muscles won’t be spastic once the nerve fibers are severed since they can’t grow again.

Physical Therapy

Children who always walked with a scissoring gait may do so even after their stiffness has been greatly decreased. Surgery, nerve blockers, and muscle relaxants may reduce stiffness, but they won’t teach your child how to walk correctly. It will seem strange for your child to walk normally if they have walked for an extended period with a scissoring gait. Children must undergo physical therapy and adopt new walking techniques in order to correct their form. A physical therapist will evaluate your child’s mobility and develop a special exercise program for them to work on their gait. The more children walk with a proper form, the more their brain circuits may get stronger and the movement pattern will feel more natural.

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at four convenient locations: Arlington, Dallas, Frisco and McKinney.