When the operating room's shadowless lamp first shone on Lila's face, the 10-year-old girl was clinging tightly to the edge of the surgical bed with her tiptoes. Her knees were pulled inward as if by invisible strings, and her heels remained 3 centimeters above the bed surface—a typical spastic gait of children with cerebral palsy, and a "posture code" that Dr. Chou Xiaobing had encountered most frequently in his 20-year medical career.
"Grade 3 Achilles tendon contracture, 23-degree hip joint subluxation," Dr. Chou noted on the preoperative assessment form. Meanwhile, Lila's mother was scrolling through old videos on her phone: the little girl, just learning to walk, stumbled like a wobbly fawn, tripping every three steps due to inward leg rotation. The local hospital had said, "Wait until she's an adult for surgery," a statement that led the family to move from one hospital to another over six years, visiting seven in total.
In the operating room on a late autumn day in 2022, the waveforms on the monitor fluctuated with Lila's breathing. Dr. Chou held a specially made No. 5 nerve retractor and made a 1.5-centimeter incision in the popliteal fossa. "The multi-planar release starts here," he said. He first severed part of the gastrocnemius insertion, then separated the tibial nerve branches from the spastic muscles—this action required precision comparable to embroidery on a steel wire, as the nerve sheath is only 0.3 millimeters thick.
"Muscle tone has dropped to Ashworth Grade 1," the assistant reported. At that moment, Dr. Chou was adjusting the angle of tendon transposition. By transferring the tibialis anterior insertion to the base of the 3rd metatarsal, the originally inverted arch of the foot gradually returned to its normal curvature. Throughout the process, he kept a close eye on the intraoperative electromyography monitor to ensure that each incision avoided the main motor nerve branches.
On the third day after the surgery, when the nurse removed the cast, Lila placed her entire foot on the ground for the first time. The moment she tentatively lifted her heel, tears suddenly welled up in her eyes—she had been practicing this simple movement for a full eight years. Dr. Chou measured with a protractor: "Ankle mobility reaches 75 degrees, 15 degrees more than the clinical standard."
On the follow-up visit day, Lila was trotting down the corridor in her new sneakers. Her gait still had a slight inward rotation, but she could now walk 500 meters continuously without tripping. As Dr. Chou reviewed the rehabilitation records, Lila suddenly stood on tiptoe to reach for the stethoscope in the pocket of his white coat—this time, her heel could easily touch the ground.
"Cerebral palsy surgery is not like repairing a machine; it's about re-teaching muscles to listen to the nerves," Dr. Chou thought, watching the girl skip and rush into her mother's arms, recalling his mentor's words from years ago. Outside the clinic window, the late autumn sun stretched their shadows long, and the two closely intertwined silhouettes finally had no tiptoeing curve.
Now, Lila can participate in the school's rope skipping competition. Every time she leaps, the pale pink scar on her ankle stretches along with her—it's a mark left by Dr. Chou's multi-planar release surgery, and a medal for a girl who went from "tiptoe walking" to "leaping into the air."
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