Article

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).

Langue : ANGLAIS