The relation of patient satisfaction and functional and cosmetic outcome after correction of the wrist flexion deformity in cerebral palsy

2010 ◽  
Vol 36 (2) ◽  
pp. 141-146 ◽  
Author(s):  
K. Libberecht ◽  
S. R. Sabapathy ◽  
P. Bhardwaj
Keyword(s):  
Cerebral Palsy ◽  
Patient Satisfaction ◽  
Cosmetic Outcome ◽  
Functional Improvement ◽  
Wrist Flexion ◽  
Flexion Deformity ◽  
Flexor Carpi Ulnaris ◽  
Determining Factors ◽  
Extensor Carpi Radialis ◽  
Over Time

Wrist flexion deformity in cerebral palsy is treated with flexor carpi ulnaris to extensor carpi radialis brevis transfer. The aim of the study was to assess the outcome of this procedure and analyse the determining factors for patient satisfaction. Fifteen patients were reviewed after a mean follow-up of 23 months. The functional and cosmetic outcome and patient satisfaction were evaluated using patient rated scales. There was a strong and significant correlation between the cosmetic outcome and patient satisfaction, but there was no significant correlation between functional improvement and patient satisfaction. When analysing the cosmetic outcome in relation to the time since surgery, there was a decrease in the patient rated improvement over time. It seems that patient satisfaction is mainly determined by the cosmetic result, but the improvement, or the perception of it, tends to diminish over time. Fourteen out of 15 patients felt that the procedure was worthwhile and eight of them felt that the result was good or excellent.

A prospective study on transfer of pronator teres to extensor carpi radialis brevis for forearm and wrist deformity in children with cerebral palsy

2020 ◽  
pp. 175319342096033
Author(s):  
Gobinder Singh ◽  
Vivek Singh ◽  
Sabeel Ahmad ◽  
R. B. Kalia ◽  
Shobha S. Arora ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Pronator Teres ◽  
Upper Limb Function ◽  
Children With Cerebral Palsy ◽  
Group 2 ◽  
A Prospective Study ◽  
Extensor Carpi Radialis ◽  
Manual Ability Classification System

We prospectively evaluated the clinical and functional outcomes of pronator teres to extensor carpi radialis brevis transfer in children with cerebral palsy. Patients were followed-up at 6 months postoperatively, and functionally assessed using the House classification, Manual Ability Classification System (MACS) and Upper Extremity Functional Index (UEFI). Fifteen children with a mean age of 8.1 years underwent tendon transfers. All patients were of Gschwind and Tonkin Grade 2 for pronation deformity; eight patients were of Zancolli’s classification Group 1 and seven, Group 2 for wrist flexion deformity. The average gain in active supination was 67°, and wrist extension 15°. An increase of 7.0 in the UEFI score was recorded, although no significant improvement in MACS and House classification was observed. We conclude that the pronator teres to extensor carpi radialis brevis transfer improves upper limb function through effective correction of forearm pronation and wrist flexion deformities. Level of evidence: II

scholarly journals Clinical and functional outcomes after augmented hip abductor tendon repair

2017 ◽  
Vol 28 (1) ◽  
pp. 74-83 ◽  
Author(s):  
Jay R. Ebert ◽  
Thomas A. Bucher ◽  
Conor J. Mullan ◽  
Gregory C. Janes
Keyword(s):  
Patient Satisfaction ◽  
Failure Rate ◽  
Functional Outcomes ◽  
Functional Improvement ◽  
Iliotibial Band ◽  
Global Rating ◽  
Limited Information ◽  
Post Surgery ◽  
Hip Abductor ◽  
Over Time

Introduction: Hip abductor tendon (HAT) tearing is commonly implicated in greater trochanteric pain syndrome. Surgical studies are often reported in small cohorts and with limited information on functional improvement. This study reports the clinical and functional outcomes after HAT repair. Methods: 112 patients with symptomatic HAT tears, diagnosed via magnetic resonance imaging, underwent open bursectomy, V-Y lengthening of the iliotibial band, debridement of the diseased tendon, decortication of the trochanteric foot-plate and reattachment of the tendon with suture anchors, augmented with a LARS ligament through a trans-osseous tunnel. Patients were evaluated pre-surgery and at 3, 6 and 12 months post-surgery using the Harris (HHS) and Oxford (OHS) Hip Scores, SF-12, hip range of motion, 6-minute walk and 30-second single leg stance tests. Maximal isometric hip abduction strength (HAS) was assessed and limb symmetry indices (LSIs) were calculated between the operated and non-operated limbs. Patient satisfaction and perceived global rating of change (GRC) was evaluated. Analysis of variance evaluated improvement over time. Results: There was a significant improvement (p<0.05) in all clinical and functional measures. HAS significantly improved over time (p<0.002) and all LSIs were >85% at 12 months. At 12 months, a mean GRC score of 3.5 (range -1 to 5) was reported, while 96% of patients were satisfied with their surgical outcome. There was a 2.7% (n = 3) failure rate at 12 months. Conclusions: HAT reconstruction, augmented with a synthetic ligament, demonstrated significantly improved clinical and functional outcomes, high levels of patient satisfaction and a low failure rate to 12 months post-surgery.

Flexor Carpi Ulnaris Tendon Transfers in Cerebral Palsy

1998 ◽  
Vol 23 (3) ◽  
pp. 340-343 ◽  
Author(s):  
T. M. WOLF ◽  
C. M. CLINKSCALES ◽  
C. HAMLIN
Keyword(s):  
Cerebral Palsy ◽  
Retrospective Study ◽  
Tendon Transfer ◽  
Standard Procedure ◽  
Extensor Digitorum ◽  
Outcome Predictors ◽  
Tendon Transfers ◽  
Flexor Carpi Ulnaris ◽  
Extensor Carpi Radialis

Flexor carpi ulnaris tendon transfer to either the extensor carpi radialis longus or extensor carpi radialis brevis has become a standard procedure to improve function in patients with cerebral palsy. In this retrospective study of the procedure, we have compared preoperative and postoperative wrist position, analysed potential outcome predictors and assessed function by objective and subjective measures. Sixteen children, with flexor carpi ulnaris transfer to extensor carpi radialis longus or brevis or extensor digitorum, were tested at an average follow-up of 4 years (range, 1–9). General resting position improved and the centre of the arc of motion averaged 6° pronation and 9° extension. Subjectively, 14 of 16 parents felt there was an improvement in function, 16 of 16 felt that cosmesis was improved, 14 of 16 would recommend the procedure to others, and 15 of 16 were satisfied overall.

scholarly journals ТREATMENT STRATEGY OF FLEXION CONTRACTURE OF THE WRIST JOINT IN CHILDREN WITH CEREBRAL PALSY

2014 ◽  
Vol 2 (3) ◽  
pp. 40-46
Author(s):  
Vladimir Alexandrovich Novikov ◽  
Valery Vladimirovich Umnov ◽  
Alexei Vasilievich Zvozil
Keyword(s):  
Cerebral Palsy ◽  
Upper Limb ◽  
Wrist Joint ◽  
Good Method ◽  
Flexion Contracture ◽  
Extension Deficit ◽  
Serial Casting ◽  
Flexor Carpi Ulnaris ◽  
Children With Cerebral Palsy ◽  
Extensor Carpi Radialis

Objectives. The objective of study was to assess the effectiveness of transplantation of m. flexor carpi ulnaris tendon on the place of m. extensor carpi radialis brevis / longus (Green operation) to eliminate the deficit of active wrist joint extension in children with cerebral palsy. Materials and methods. The present study is based on a survey of children with cerebral palsy with affected upper limb. The main criterion for selection of patients was the presence of active extension deficit in the wrist joint, both isolated and in combination with other contractures of the upper limb joints. Total 22 patients with spastic forms of cerebral palsy were examined. Results and conclusions. Green operation is a good method of surgical treatment of active extension deficit in the wrist joint in patients with cerebral palsy. In the presence of moderately severe contractures in the wrist joint, serial casting can eliminate them completely. Presence of a fixed pronation contracture of the forearm is a factor that reduces the effectiveness of FCU transplantation. Pronation contracture should be corrected before or during Green surgery. FCU transplantation is effective for children of any age, but its effectiveness is reduced from 12 years old.

scholarly journals Spastic wrist flexion in cerebral palsy. Pronator teres versus flexor carpi ulnaris transfer

2015 ◽  
Vol 23 (3) ◽  
pp. 150-153 ◽  
Author(s):  
Edgard de Novaes França Bisneto ◽  
Nivea Rizzi ◽  
Eliana Ogassawara Setani ◽  
Livia Casagrande ◽  
Joseane Fonseca ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Wrist Flexion ◽  
Pronator Teres ◽  
Flexor Carpi Ulnaris
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