scholarly journals To what extent can soft-tissue releases improve hip displacement in cerebral palsy?

2017 ◽  
Vol 88 (6) ◽  
pp. 695-700 ◽  
Author(s):  
Terje Terjesen
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Hip Displacement

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.

scholarly journals Risk factors for hip dislocation in dyskinetic cerebral palsy

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110011
Author(s):  
Kyoko Okuno ◽  
Yukihiro Kitai ◽  
Toru Shibata ◽  
Hiroshi Arai
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Birth Weight ◽  
Gestational Age ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Lesion Location ◽  
Hip Displacement ◽  
Gmfcs Level

Purpose: To investigate the risk factors for hip displacement in patients with dyskinetic cerebral palsy (DCP). Methods: We evaluated 81 patients with DCP, 45 males and 36 females, aged 10–22 years, risk factors for hip displacement were evaluated using multivariate logistic regression analysis with primary brain lesions, Gross Motor Function Classification System (GMFCS) level, gestational age, birth weight, Cobb’s angle, and complication of epilepsy as independent factors. Hip displacement was defined as migration percentage >30%. Primary brain lesions were classified into globus pallidus (GP), thalamus and putamen (TP), and others using brain magnetic resonance imaging (MRI). Perinatal and clinical features were compared between patients with GP lesions and those with TP lesions. Results: Hip displacement was observed in 53 patients (67%). Higher GMFCS levels (p = 0.013, odds ratio [OR] 2.6) and the presence of GP lesions (p = 0.04, OR 16.5) were independent risk factors for hip displacement. Patients with GP lesions showed significantly higher GMFCS levels, more frequent hip displacement, and lower gestational age and birth weight than those with TP lesions. Conclusion: Primary brain lesion location may be an important factor in predicting hip displacement among patients with DCP. Appropriate risk assessment using brain MRI may contribute to the early detection and intervention of hip displacement because brain lesion location can be assessed during infancy before GMFCS level is decided.

Hip surgery and radiology reporting for children with cerebral palsy prior to initiation of a hip surveillance program

2021 ◽  
pp. 1-7
Author(s):  
Kyra Kane ◽  
Marshall Siemens ◽  
Shane Wunder ◽  
Jacqueline Kraushaar ◽  
J. Alexandra Mortimer ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Retrospective Chart Review ◽  
Surveillance Program ◽  
Radiology Reporting ◽  
Reporting Practices ◽  
Hip Displacement ◽  
Primary Surgery ◽  
Radiology Reports ◽  
Children With Cerebral Palsy ◽  
Surveillance Programs

PURPOSE: Hip displacement impacts quality of life for many children with cerebral palsy (CP). While early detection can help avoid dislocation and late-stage surgery, formalized surveillance programs are not ubiquitous. This study aimed to examine: 1) surgical practices around pediatric hip displacement for children with CP in a region without formalized hip surveillance; and 2) utility of MP compared to traditional radiology reporting for quantifying displacement. METHODS: A retrospective chart review examined hip displacement surgeries performed on children with CP between 2007–2016. Surgeries were classified as preventative, reconstructive, or salvage. Pre- and post-operative migration percentage (MP) was calculated for available radiographs using a mobile application and compared using Wilcoxon Signed Ranks test. MPs were also compared with descriptions in the corresponding radiology reports using directed and conventional content analyses. RESULTS: Data from 67 children (115 surgical hips) was included. Primary surgery types included preventative (63.5% hips), reconstructive (36.5%), or salvage (0%). For the 92 hips with both radiology reports and radiographs available, reports contained a range of descriptors that inconsistently reflected the retrospectively-calculated MPs. CONCLUSION: Current radiology reporting practices do not appear to effectively describe hip displacement for children with CP. Therefore, standardized reporting of MP is recommended.

scholarly journals Soft Tissue Release and Osteotomies in the Treatment of Patients with Spastic Diplegic Cerebral Palsy

2018 ◽  
Vol 24 (1) ◽  
pp. 80-83
Author(s):  
Ng Bobby Kin-Wah ◽  
Chau Wai-Wang ◽  
Hung Alec Lik-Hang ◽  
Lam Tsz-Ping ◽  
Cheng Jack Chun-Yiu
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Soft Tissue Release ◽  
Spastic Diplegia ◽  
Single Event ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Surgery Patient ◽  
Before And After ◽  
Mid Term Results

We aim to study the outcome of soft tissue releases by tendon elongations and osteotomies in fixed joint contractures by clinical examination and patient self-reported assessment on 20 patients (14 males and 6 females) with spastic diplegic cerebral palsy treated with single-event multilevel surgery (SEMLS) between 2000 and 2012. A questionnaire was used to collect information on problems encountered before and after surgery and decision on surgery. Comparing patients with Gross Motor Function Classification System class I/II, (N = 8), III (N = 8) and IV/V, patients of classes IV/V showed much slower mean recovery time than I/II group (14.00 vs. 4.38 months, p < 0.01). SEMLS in the treatment of patients with spastic diplegia had good mid-term results in most patients. The patients who had unfavourable outcomes are associated with mental retardation, general or local complications and previous selective dorsal rhizotomy surgery. Patient selection and good rehabilitations preoperation and postoperation provided the most favourable outcomes of SEMLS.

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