Document Detail


Effects of orthopedic intervention in adolescents and young adults with cerebral palsy.
MedLine Citation:
PMID:  19487127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to determine the effects of orthopedic procedures performed after skeletal maturity on ambulatory patients with cerebral palsy. Twenty-five patients (46 sides) had pre- and postoperative computerized gait analysis. All patients underwent any one or a combination of the following procedures: hamstring lengthenings, ankle plantar flexor lengthenings, rectus femoris transfers, psoas lengthenings, and femoral derotation osteotomies. Surgical results were similar in this group of older patients to those for younger individuals with cerebral palsy. Surgical procedures were evaluated pre- versus postoperatively within the subgroups of patients that had a particular procedure. Patients experienced the following results 1 year postoperatively: (1) improved knee extension at initial contact following hamstring lengthenings (n=35 sides, preop=32+/-15 degrees, postop=22+/-13 degrees, p<0.01), (2) improved peak dorsiflexion in swing (n=23 sides, preop=-1+/-9 degrees, postop=6+/-8 degrees, p<0.01) and improved modulation with peak dorsiflexion occurring later in stance (preop=31+/-15% of gait cycle, postop=43+/-13% of gait cycle, p<0.01) following ankle plantar flexor lengthenings, (3) improved hip rotation following femoral derotational osteotomies (n=9 sides, preop=19+/-12 degrees internal, postop=0+/-12 degrees, p<0.01), (4) improved peak knee flexion in swing following rectus femoris transfers (n=23 sides, preop=47+/-11 degrees, postop=55+/-13 degrees, p=0.01), (5) a reduction in excessive hip flexion during terminal stance was found in those patients with psoas lengthening (n=8 sides, preop=18+/-21 degrees, postop=9+/-19 degrees, p=0.04).
Authors:
Melany Westwell; Sylvia Ounpuu; Peter DeLuca
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Publication Detail:
Type:  Journal Article     Date:  2009-05-31
Journal Detail:
Title:  Gait & posture     Volume:  30     ISSN:  1879-2219     ISO Abbreviation:  Gait Posture     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-03     Completed Date:  2009-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9416830     Medline TA:  Gait Posture     Country:  England    
Other Details:
Languages:  eng     Pagination:  201-6     Citation Subset:  IM    
Affiliation:
Connecticut Children's Medical Center, Center for Motion Analysis, 399 Farmington Ave, Farmington, CT 06032, USA. mwestwe@ccmckids.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Cerebral Palsy / rehabilitation,  surgery*
Female
Gait Disorders, Neurologic / rehabilitation,  surgery*
Humans
Male
Muscle, Skeletal / surgery*
Orthopedic Procedures*
Osteotomy*
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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