Importance of the iliopsoas muscle in soft-tissue surgery of hip deformities in cerebral palsy children

1989 ◽  
Vol 108 (4) ◽  
pp. 225-230 ◽  
Author(s):  
M. Feldkamp ◽  
P. Denker
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Iliopsoas Muscle ◽  
Soft Tissue Surgery

scholarly journals Soft tissue surgery as an initial treatment for hip displacement in spastic cerebral palsy

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 38
Author(s):  
Luiz Antônio Angelo da Silva ◽  
Patricia Maria de Moraes Barros Fucs
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Small Sample ◽  
Acetabular Index ◽  
Soft Tissue Release ◽  
Spastic Cerebral Palsy ◽  
Hip Displacement ◽  
Migration Percentage ◽  
Soft Tissue Surgery

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.

The Hip in Children With Cerebral Palsy: Predicting the Outcome of Soft Tissue Surgery

1997 ◽  
Vol 340 ◽  
pp. 165-171 ◽  
Author(s):  
Mark S. Cornell ◽  
N. Cameron Hatrick ◽  
Roslyn Boyd ◽  
Gillian Baird ◽  
John D. Spencer
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Children With Cerebral Palsy ◽  
Soft Tissue Surgery

scholarly journals Lower extremity soft tissue surgery in spastic cerebral palsy: experience from a government rehabilitation unit

2018 ◽  
Vol 4 (2) ◽  
pp. 214
Author(s):  
Adiveppa Hosangadi ◽  
Anand Varma ◽  
Surykanth Kalluraya
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Lower Limb ◽  
Operative Procedure ◽  
Lower Limbs ◽  
Spastic Cerebral Palsy ◽  
Functional Abilities ◽  
Rehabilitation Unit ◽  
Lower Limb Surgery ◽  
Soft Tissue Surgery

<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>

Kinematic and Kinetic Outcomes After Identical Multilevel Soft Tissue Surgery in Children With Cerebral Palsy

2007 ◽  
Vol 27 (6) ◽  
pp. 658-667 ◽  
Author(s):  
Stephen E. Adolfsen ◽  
Sylvia Õunpuu ◽  
Katharine J. Bell ◽  
Peter A. DeLuca
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Children With Cerebral Palsy ◽  
Soft Tissue Surgery

Evolution of walking ability after soft tissue surgery in cerebral palsy patients: what can we expect?

2008 ◽  
Vol 17 (3) ◽  
pp. 107-113 ◽  
Author(s):  
Martin Svehlik ◽  
Krystof Slaby ◽  
Libor Soumar ◽  
Pavel Smetana ◽  
Alena Kobesova ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Walking Ability ◽  
Soft Tissue Surgery

scholarly journals GP11 Efficacy of soft tissue surgery for flexion knee contractures in children with cerebral palsy

2019 ◽  
Author(s):  
Maria Volkova ◽  
Konstantin Zherdev ◽  
Oleg Chelpachenko ◽  
Ivan Nikitenko
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Children With Cerebral Palsy ◽  
Soft Tissue Surgery

scholarly journals Effects of soft tissue surgery on transverse kinematics in patients with cerebral palsy

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Byeong-Seop Park ◽  
Chin Youb Chung ◽  
Moon Seok Park ◽  
Kyoung Min Lee ◽  
Seong Hee Cho ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Transverse Plane ◽  
Ankle Dorsiflexion ◽  
Initial Contact ◽  
Tibial Rotation ◽  
Affecting Factors ◽  
Foot Progression Angle ◽  
External Angle ◽  
Soft Tissue Surgery

Abstract Background Gait disturbances, including flexed knee gait, stiff knee gait, and tip-toeing gait, are common in patients with cerebral palsy (CP). There has been no reports regarding kinematic changes in the transverse plane after soft tissue surgeries, such as distal hamstring lengthening (DHL), rectus femoris transfer (RFT), and tendo-Achilles lengthening (TAL). This study aimed to evaluate changes in the transverse plane after soft tissue surgery in patients with CP by assessing the effects of the DHL, RFT, and TAL. Methods The study enrolled 156 consecutive patients (mean age, 8.4 years; range, 4.4 to 20.9), representing 213 operated limbs, who underwent soft tissue surgery including DHL with semitendinosus transfer, RFT, and TAL. All patients were assessed by preoperative and 1-year postoperative three-dimensional gait analysis. Changes in transverse plane kinematics after soft tissue surgery and affecting factors were analyzed. Results Sagittal kinematics including knee flexion at initial contact, ankle dorsiflexion at initial contact, and mean ankle dorsiflexion in the stance phase were significantly improved after single event multilevel surgery (all p < 0.001). Transverse kinematics, including mean tibial rotation and foot progression angle, were significantly improved to a more external angle after soft tissue surgeries (− 2.9°, p = 0.004 and − 9.5°, p < 0.001). The mean hip rotation was significantly improved to a more external angle by RFT (− 4.7°, p = 0.010) and the foot progression angle was significantly improved to a more external angle by TAL (− 3.9°, p = 0.028). Conclusions This study found that the transverse kinematics were improved to a more external angle after soft tissue surgery in patients with CP. Therefore, clinicians should consider that soft tissue surgery can affect the transverse plane kinematics in patients with CP. To confirm our findings, further research regarding the natural history of femoral and tibial torsion in children with CP is needed.

scholarly journals Outcomes of isolated soft tissue surgery for in-toeing gait in patients with ambulatory cerebral palsy

2020 ◽  
Vol 106 (7) ◽  
pp. 1367-1371
Author(s):  
Bruno Dohin ◽  
Elie Haddad ◽  
Bérénice Zagorda-Pallandre ◽  
Marion Zemour
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Soft Tissue Surgery
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