Outcome of adductor tenotomy in children with spastic cerebral palsy at Soba University Hospital

Samir Shaheen, Elsamani A. Mahmoud

Abstract


Introduction: Cerebral palsy (CP) is a common neurodevelopmental condition that causes physical
disability during childhood. Its spastic type accounts for 70% of cases. Adductor tenotomy, as one of the
useful surgical procedures that solves many of the problems that interfere with daily activities of the patient
and with personal hygiene. Moreover, the procedure reduces the tendency of lateral displacement of the
femoral head and prevents subluxation and painful dislocation.
Objective: to assess the outcome of adductor tenotomy in children with spastic CP who presented to Soba
University Hospital (SUH) with hip adduction deformity from 2003 to 2013.
Methods: Records of all patients of CP at SUH were reviewed, for demographic characteristics, pattern
of presentation, and degree of disability. Preoperative and postoperative physical and functional status was
reviewed.
Results: Forty-two (out of 224) patients with CP underwent surgery and were included in this study. Their
age group ranged between 21 months and 15 years (mean age 7.73 years). Females constituted 54.8%, 23
of the 42 patients. Twenty-eight patients (66.7 %) were diaplegic. All the 42 patients underwent a standard
adductor tenotomy. Four factors were found to be statistically significant in improving the postoperative
physical status after the surgery; these were type of spastic CP, the preoperative physical status, Reimers
Index and the mental status.

Keywords


Outcome ;adductor ;tenotomy;children; spastic ;cerebral ;palsy; Soba ;University; Hospital

Full Text:

PDF

References


Bax M, Goldstein M, Rosenbaum P, et al.

Proposed definition and classification of

cerebral palsy. Dev Medicine Child Neuro.

;47:571-6.

Data & Statistics for Cerebral Palsy2013.

http://www.cdc.gov/ncbddd/cp/data.html. Date

of access 11 March 2014.

Damiano DL, Alter KE, Chambers H. New

clinical and research trends in lower extremity

management for ambulatory children with

cerebral palsy. Physical medicine and

rehabilitation clinics of North America.

;20:469-91.

Sawyer JR. Nervous System Disorders in

Children, Cerebral Palsy. In: Canale ST, Beaty

JH, editors. Campbel’s Operative Orthopaedics.

th edition. Philadelphia: Mosby; 2011.p.1333

– 88.

Persson-Bunke M, Hagglund G, Lauge-

Pedersen H. Windswept hip deformity in

children with cerebral palsy. J Pediatr Orthoped

B. 2006;15:335-8.

Morris C. Orthotic Management of Children

with Cerebral Palsy. J Prosthet Orthot.

;14:150-8.

Palisano R, Rosenbaum P, Walter S, Russell

D, Wood E, Galuppi B. Development and

reliability of a system to classify gross motor

function in children with cerebral palsy. Dev

Medicine Child Neuro. 1997;39:214-23.

Zeldin, A.S. and Kao, A. Intellectual Disability.

emedicine.medscape.com/article/1180709-

clinical. March 2014.

Pap K, Kiss S, Vizkelety T, Szoke G. Open

adductor tenotomy in the prevention of hip

subluxation in cerebral palsy. Int Orthop.

;29:18-20.

Outcome of adductor tenotomy in children with spastic cerebral palsy at Soba University Hospital

Cottalorda J, Gautheron V, Metton G, Charmet

E, Maatougui K, Chavrier Y. Predicting the

outcome of adductor tenotomy. Int Orthop.

;22:374-9.

Guglielmetti, L.G.B., Santos, R.M.M., De

Mendonca, R.G.M.,et al. Results of Adductors

Muscles Tenotomy in Spastic Cerebral Palsy.

Rev Bras Ortop. 2010;45:420 - 5.

Moreau M, Cook PC, Ashton B. Adductor

and psoas release for subluxation of the hip in

children with spastic cerebral palsy. J Pediat

Orthoped. 1995;15:672-6.

Berker N, Yalçin S. The HELP Guide to Cerebral

Palsy. 2nd Ed. Seatel, Global-Help Publications.

(2010).

Presedo A, Oh CW, Dabney KW, Miller F. Softtissue

releases to treat spastic hip subluxation

in children with cerebral palsy. J Bone Joint

Surgery Am. 2005;87:832-41.

Shore BJ, Yu X, Desai S, Selber P, Wolfe R,

Graham HK. Adductor surgery to prevent hip

displacement in children with cerebral palsy:

the predictive role of the Gross Motor Function

Classification System.J Bone Joint Surgery Am.

;94:326-34.

Souder C. cerebral palsy-Hip conditions.

http://www.orthobullets.com/pediatrics/4084/

cerebral-palsy-generalAccess date March 2014.

Terjesen T, Lie GD, Hyldmo AA, Knaus A.

Adductor tenotomy in spastic cerebral palsy. A

long-term follow-up study of 78 patients. Acta

orthopaedica. 2005;76:128-37.

Rolauffs B SF, Barth S, Ochs BG, et al.

[Prophylaxis and therapy for hip dislocations

in patients with infantile cerebral palsy (ICP):

motor functional, radiological and clinical

results after subcutaneous adductor tenotomy. Z

Orthop Unfall. 2007;145:505-10.

Piasek R, Snela S, Rydzak B. Effectiveness

of two methods of treatment of the spastic

hip in CP children. Ortopedia, traumatologia,

rehabilitacja. 2011;13:185-9.

Miller F, Cardoso Dias R, Dabney KW, Lipton

GE, Triana M. Soft-tissue release for spastic

hip subluxation in cerebral palsy. J Pediat

Orthoped. 1997;17:571-84.


Refbacks

  • There are currently no refbacks.


ISSN: 1858-5345