scholarly journals Soft Tissue Surgery for Equinus Deformity in Spastic Hemiplegic Cerebral Palsy: Effects on Kinematic and Kinetic Parameters

2006 ◽  
Vol 47 (5) ◽  
pp. 657 ◽  
Author(s):  
Chang Il Park ◽  
Eun Sook Park ◽  
Hyun Woo Kim ◽  
Dong-wook Rha
SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 38
Author(s):  
Luiz Antônio Angelo da Silva ◽  
Patricia Maria de Moraes Barros Fucs

Objective: To use the measurement of migration percentage (MP) to evaluate the long-term radiographic results of soft tissue surgery as the first treatment for hip displacement in spastic bilateral cerebral palsy. A secondary objective was to identify predictive factors of stability (i.e., less than 30% of MP in the long term), after surgical correction. Methods: In this longitudinal cohort study, we reviewed the electronic medical records and radiographs of all consecutive patients with cerebral palsy operated for the correction of hip displacement between 1984 and 2013 in a referral orthopedic public hospital in Brazil. Patients were included if they had received, as the first surgical procedure, soft-tissue release. All surgeries were bilateral and symmetrical. We used the available radiographs to evaluate the migration percentage (MP), acetabular index (AI), pelvic obliquity (PO) angle, head-shaft angle (HSA), congruence and femoral head sphericity, and function using the GMFCS (Gross Motor Function Classification System). Results: we included 93 patients, all operated before being 12 years old, with follow-up of 10 years in average, 73 (78%) of them with good results (MP < 30%). We found association between preoperative MP ≤ 40%, AI ≤ 25°, and postoperative symmetry with good results, with a cut-off value of 38% of MP and 27° of acetabular index being predictive. Discussion: The role of soft tissue releases remains controversial owing to small sample sizes, heterogeneity, variety range of ages, definitions used for outcome, and lack of statistical quality. Our results were better in combined tenotomies, in diparetic patients aged more than six years, and in patients with lower initial values of MP and AI. Radiographic variables had good correlation with each other and association with results, with cut-off values for MP and AI PRE.


1997 ◽  
Vol 340 ◽  
pp. 165-171 ◽  
Author(s):  
Mark S. Cornell ◽  
N. Cameron Hatrick ◽  
Roslyn Boyd ◽  
Gillian Baird ◽  
John D. Spencer

Author(s):  
Adiveppa Hosangadi ◽  
Anand Varma ◽  
Surykanth Kalluraya

<p class="abstract"><strong>Background:</strong> <span>Spastic cerebral palsy (CP) remains the most common type of CP and may be managed surgically or non-surgically depending upon its severity. Recent advances have replaced single-level surgery by the concept of multilevel surgery where multiple levels of musculoskeletal pathology, in one/both lower limbs, are addressed during one operative procedure, requiring only one hospital admission and one period of rehabilitation. This study assessed the outcome of lower limb soft tissue surgery in children with spastic CP in a government rehabilitation unit and measured its feasibility with limited infrastructure facilities and patient compliance</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span>The study comprised of 26 patients aged between 2-12 years. Physical examination and GMFCS scores were recorded and evaluation of sitting balance, standing balance and gait were done. Musculotendinous soft tissue lower limb surgery was performed at one or more levels unilaterally or bilaterally and the results were interpreted</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span>Complete or near complete correction of deformities were attained by all children postoperatively. Significant improvements were noted in the gross motor functional classification system (GMFCS) scores. All parents and children were satisfied with the surgical outcome and reported improvement in functional abilities and locomotion in the follow-up along with better quality of life and mobility</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span>Lower limb soft tissue surgery is a valuable aid in improving functional abilities and locomotion in children with spastic CP. Surgery should be undertaken depending upon clinical indications and can be successfully carried out in government hospitals with ordinary infrastructure in developing countries as well</span><span lang="EN-IN">.</span></p>


2007 ◽  
Vol 27 (6) ◽  
pp. 658-667 ◽  
Author(s):  
Stephen E. Adolfsen ◽  
Sylvia Õunpuu ◽  
Katharine J. Bell ◽  
Peter A. DeLuca

2008 ◽  
Vol 17 (3) ◽  
pp. 107-113 ◽  
Author(s):  
Martin Svehlik ◽  
Krystof Slaby ◽  
Libor Soumar ◽  
Pavel Smetana ◽  
Alena Kobesova ◽  
...  

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