Pronator teres selective neurectomy in children with cerebral palsy

2018 ◽  
Vol 43 (8) ◽  
pp. 879-884 ◽  
Author(s):  
Marion Helin ◽  
Manon Bachy ◽  
Claire Stanchina ◽  
Frank Fitoussi
Keyword(s):  
Cerebral Palsy ◽  
Botulinum Toxin Injection ◽  
Hand Function ◽  
Global Strategy ◽  
Level Of Evidence ◽  
Pronator Teres ◽  
Upper Limb Function ◽  
Children With Cerebral Palsy ◽  
Selective Neurectomy

The objective of this study was to evaluate the results after selective pronator teres (PT) neurectomy in children with spastic hemiplegia. Patients with PT spasticity without contracture and an active supination improvement after PT botulinum toxin injection were included. Hand function and deformities were evaluated with the House score, Gschwind and Tonkin pronation deformity classification and Zancolli’s classification. Twenty-two patients (mean age 11.6 years) were included in this study. The average follow-up was 32.6 months. All but one patient improved their supination with a preoperative mean active supination of 5° (range −80–70°) and postoperative of 48° (range 10–90°). Active pronation was always maintained at the last follow-up. PT selective neurectomy appears to improve active and passive forearm supination and should be included in a global strategy of treatments to improve upper limb function in children with cerebral palsy. Level of evidence: IV

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

Functional outcomes of botulinum neurotoxin-A injection followed by reciprocal electrical stimulation in children with cerebral palsy: A randomized controlled trial

2020 ◽  
pp. 1-11
Author(s):  
Ragab K. Elnaggar ◽  
Bader A. Alqahtani ◽  
Mohammed F. Elbanna
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Botulinum Neurotoxin ◽  
Hand Function ◽  
Botulinum Neurotoxin A ◽  
Group Iii ◽  
Children With Cerebral Palsy ◽  
Spastic Hemiplegia ◽  
Upper Extremity Function

Background: The integration of therapeutic approaches is increasingly recommended for children with cerebral palsy, to enhance outcomes. Nevertheless, clinicians still opt for separate or combined therapies based on little credible knowledge. Objective: This study endeavored to evaluate the effect of botulinum neurotoxin-A (BoNT-A) injection and reciprocal neuromuscular electrical stimulation (rNMES) and their combination on the upper extremity function in children with spastic hemiplegia. Methods: Sixty-four children with spastic hemiplegia (aged 6– 10 years) were randomly assigned to four treatment-based groups [group I (BoNT-A), group II (rNMES), group III (combined BoNT-A and rNMES), and group IV (Control)]. All children received a physical rehabilitation program, thrice/week over three months. Unilateral upper-limb function, bimanual hand function, and real-time arm-hand function were assessed using Melbourne Assessment (MA), Assisting Hand Assessment (AHA), and Pediatric Motor Activity Log (PMAL) scales respectively pre-treatment, post-treatment, and at 6 months follow-up. Results: Post-treatment, group III achieved greater improvement in MA, AHA, and PMAL compared to other groups (all P <  0.05), and the difference remained in favor of group III at the follow-up (all P <  0.05). Conclusions: This study suggests that BoNT-A and rNMES combined are more effective than either of them alone to enhance upper-extremity function in children with spastic hemiplegia.

scholarly journals The unstable hip in children with cerebral palsy: does an acetabuloplasty add midterm stability?

2021 ◽  
pp. 1-7
Author(s):  
Matthias W. Axt ◽  
Danielle L. Wadley
Keyword(s):  
Cerebral Palsy ◽  
Classification System ◽  
Group Versus ◽  
Level Of Evidence ◽  
Hip Stability ◽  
Children With Cerebral Palsy ◽  
Migration Percentage ◽  
Outcome Difference ◽  
Retrospective Comparative Study

Purpose This study addresses whether an additional pelvic procedure is superior to a varus derotation osteotomy femur (VDRO) alone in unstable hips in children with cerebral palsy (CP). Methods All patients had unstable hips utilising the Melbourne Cerebral Palsy Hip Classification System (MCPHCS). We compared one group that underwent VDRO alone with one that had a combination of VDRO and Dega osteotomy (VDRO+). Measurements were taken before surgery, postoperatively, two years after surgery and at latest follow-up. Generalised estimating equations were used to account for known and unknown correlations between hips from bilateral cases. Results In total, 74 hips in 57 children fulfilled the inclusion criteria. There was no outcome difference between Gross Motor Function Classification System levels III, IV and V. Age at time of operation ranged from three to 16 years (mean 9.8 years). Mean follow-up was 49.1 months. In the VDRO group (28 hips) migration percentage (MP) changed from 61% preoperative to a final value of 35.7%. In the VDRO+ group (46 hips) the MP changed from 64.4% to 19.3%. At final follow-up 15 hips (54%) were stable in the VDRO group, 37 hips (83%) in the VDRO+ group. The odds ratio (OR) of hip stability at final follow-up was 3.5-times higher in the VDRO+ group versus the VDRO group (OR = 3.9; 95% confidence interval = 1.5 to 9.7; p = 0.004). Conclusion Reconstruction of unstable hips via VDRO + Dega in children with CP provides a higher likelihood of long-term stability than an isolated VDRO. Level of Evidence Level III, retrospective comparative study

scholarly journals Prophylactic antibiotics in soft-tissue procedures in children with cerebral palsy

2018 ◽  
Vol 12 (3) ◽  
pp. 279-281
Author(s):  
L. R. Perotti ◽  
O. Abousamra ◽  
K. J. Rogers ◽  
F. Miller ◽  
J. P. Sees
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Surgical Site Infections ◽  
Paediatric Population ◽  
Prophylactic Antibiotics ◽  
Level Of Evidence ◽  
Children With Cerebral Palsy ◽  
Antibiotic Group ◽  
Therapeutic Study

Purpose Data on the benefits of perioperative prophylactic antibiotics in the paediatric population are lacking. In this study, we aimed to assess the rate of infection after isolated soft-tissue procedures in patients with cerebral palsy with and without preoperative prophylactic antibiotics between 2009 and 2015. Methods We reviewed the records of all children with cerebral palsy who underwent isolated soft-tissue procedures (on the upper and lower limb) at our hospital between 2009 and 2015. Children with at least 30-day postoperative follow-up were included. Children who had groin incisions were excluded. Results Two groups were identified: the antibiotic group (77 children with 203 incisions and 343 procedures) had one surgical site infection; the no-antibiotic group (48 children with 102 incisions and 177 procedures) had no surgical site infections. Conclusion These results suggest that the use of preoperative antibiotics does not change the rate of postoperative surgical site infections. Level of Evidence Level III therapeutic study

CHILDREN WITH CEREBRAL PALSY

PEDIATRICS ◽  
1957 ◽  
Vol 20 (4) ◽  
pp. 703-715
Author(s):  
Helen M. Wallace ◽  
Margaret A. Losty ◽  
David Sanders ◽  
Robert S. Siffert ◽  
Jerome S. Tobis ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Cerebral Palsy ◽  
Financial Aid ◽  
York City ◽  
Follow Up Study ◽  
Children With Cerebral Palsy

This report describes the findings and interim results of a follow-up study of 770 children with cerebral palsy who were cared for under the aegis of the New York City Financial Aid Program from 1945 to July 1, 1954. The findings seem to indicate that some redirection of the program to include development, expansion and improvement of some alternate services within the community is advisable. It is likely that this same type of follow-up study would be of equal value for children of other diagnostic groups, and similar studies might be initiated.

scholarly journals Comparison of hamstring transfer with hamstring lengthening in ambulatory children with cerebral palsy: further follow-up

2014 ◽  
Vol 8 (6) ◽  
pp. 513-520 ◽  
Author(s):  
Camila De Mattos ◽  
K. Patrick Do ◽  
Rosemary Pierce ◽  
Jing Feng ◽  
Michael Aiona ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Children With Cerebral Palsy

scholarly journals STATURE ESTIMATE OF CHILDREN WITH CEREBRAL PALSY THROUGH SEGMENTAL MEASURES: A SYSTEMATIC REVIEW

2020 ◽  
Vol 38 ◽  
Author(s):  
Joel Alves Lamounier ◽  
Nathália Macedo Marteletto ◽  
Cristina Amaral Calixto ◽  
Marcia Reimol de Andrade ◽  
Jacqueline Domingues Tibúrcio
Keyword(s):  
Cerebral Palsy ◽  
Infant Health ◽  
Body Height ◽  
Japanese Patients ◽  
Healthcare Research ◽  
Small Samples ◽  
Children With Cerebral Palsy ◽  
Actual Height ◽  
Meta Analyses

ABSTRACT Objective: To review studies that evaluate the correspondence between the estimate height via segmental measures and the actual height of children with cerebral palsy. Data sources: Systematic literature review between 1995–2018, guided by the PRISMA criteria (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), in PubMed, BVS, MEDLINE and Lilacs databases. The descriptors, connected by the AND Boolean Operators, were: anthropometry, cerebral palsy, child and body height. The research comprised papers in Portuguese, English and Spanish, with Qualis-CAPES equal or superior to B3 that addressed the question: “Is there any correlation between estimate height by equations and direct height measures in children with cerebral palsy?” 152 studies were recovered and seven were selected. Their methodological quality was assessed by the scale of the Agency for Healthcare Research and Quality (AHRQ). Data synthesis: Most studies showed no correspondence between estimated and real height. Studies that showed coincidence of the measures contain limitations that could jeopardize the results (sample losses, small samples and exclusion of patients with severe contractures, scoliosis and severe cerebral palsy). Japanese researchers developed an equation which harmoniously aligns the statures; the study comprised only Japanese patients, though. Conclusions: Given the importance of accuracy in height measures to evaluate infant health, it is crucial to carry out more researches in order to safely establish an association between both estimate and real statures. The development of anthropometric protocols, emerged from such researches, would benefit the follow-up of children with severe psychomotor disabilities.

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