H/O LSCS premature baby

please comment on following gait pattern as I have discussed yesterday this case . Thank you. Patient age 9 yrs old ; mother came with complaint of intoeing gait . 5 years back operated for equinus gait TA release 3 week caste .after that mother came with complaint of intoeing gait . Diagnosis ?Cerebral palsy ?TA lengthening with equinus deformity

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The intoeing is coming from the femoral anteversion.. note the ranges of internal rotation and external rotation of femur... In such cases the internal rotation will be much much more than external rotation. She seems to also hv slightly tight hamstrings and the gait is more on toes than on heels - expect weakness of gluteal max, glut medius and minimus, check quadriceps lag and lack... And strength of dorsiflexors... Child is GMFCS l.. have they taken a Paediatric ortho opinion .. she may need derotation surgery at femur , this is the correct age for those surgeries... Are they on regular Physiotherapy ?

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Look for adductor tightness It could be a mild version of scissoring gait Other entity to be kept in mind is CTEV Components of CTEV that can exist in variable levels are Fore foot adduction Hind foot inversion Ankle equinous Tibial intorsion is a common association that can lead to intoeing Need clinical evaluation to confirm Get orthopaedic evaluation

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Looks like spastic gait.ortho opinion .then physio evaluation n treatment.