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SEMLS – CP multilevel surgery — RACP Paediatrics MCQ

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HardNeurologySEMLS – CP multilevel surgeryRACP Paediatrics

A 7-year-old with spastic diplegic CP (GMFCS II) has developed fixed contractures at the ankles, knees, and hips bilaterally. Gait analysis shows a crouch gait pattern with multiple lever-arm dysfunction issues. What is the most appropriate orthopaedic approach?

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Correct answer: A — SEMLS (single-event multilevel surgery)

SEMLS (single-event multilevel surgery) addresses all significant musculoskeletal deformities in a single operative session, avoiding the need for multiple staged surgeries. In spastic diplegia with crouch gait and multilevel contractures, SEMLS typically includes hamstring lengthening, rectus femoris transfer, and Achilles lengthening. Gait analysis guides surgical planning.

Reference: RCH Melbourne – 2023 – CP CPG; RACP Paediatric Curriculum – Orthopaedics/Rehabilitation