Gait Analysis in Low Lumbar Myelomeningocele Patients With Unilateral Hip Dislocation or Subluxation

Gabrieli, Ana Paula T.; Vankoski, Stephen; Dias, Luciano; Milani, Carlo; Lourenço, Alexandre; Filho, José Laredo; Novak, Robert A.

doi:10.1097/01241398-200305000-00010

Cited by 28 publications

(20 citation statements)

References 30 publications

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“…Another series examined 20 patients with low-lumbar spina bifida who walked with crutches and underwent three-dimensional gait analysis to determine the influence of unilateral hip dislocation on gait [22]. The authors reported that the walking speed of patients with dislocated hips was 60% of normal, which corresponds to the walking speed in low-lumbar patients without hip dislocation in previous studies from the same center.…”

Section: Hipmentioning

confidence: 99%

“…It is especially useful in pre-operative planning for ambulatory patients and in quantitatively assessing surgical results. Its use has been reported in the literature for analyzing many manifestations of spina bifida, including hip subluxation/ dislocation, lower extremity contractures, and rotational abnormalities [21][22][23][24][25]. Clinical evaluation of patients with spina bifida is complex and involves multiple inter-related levels of deformity.…”

Section: Gait Analysismentioning

confidence: 99%

“…The US Food and Drug Administration mandated adding folic acid to all enriched grain products by January 1998 [6]. From October 1998 to December 1999, the birthprevalence rate of spina bifida in the Unites States decreased 22.9% compared with 1995-1996 [6]. Furthermore, comparing the incidence during the period from 1999 to 2000 to the period from 2003 to 2005, the prevalence of spina bifida in the United States decreased 6.9%, from 2.04 to 1.90 per 10,000 live births [6].…”

Section: Incidencementioning

confidence: 99%

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Orthopedic management of spina bifida. Part I: Hip, knee, and rotational deformities

Swaroop

Dias

2009

Journal of Children's Orthopaedics

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Children with spina bifida develop a wide variety of congenital and acquired orthopedic deformities. Among these are hip deformities such as contracture, subluxation, or dislocation. Patients may also have problems with the knee joint, such as knee flexion or extension contracture, knee valgus deformity, or late knee instability and pain. In addition, rotational deformities of the lower extremities, either internal or external torsion, are common as well. This paper will review both the overall orthopedic care of a patient with spina bifida and provide a focused review of the diagnosis and management of the above deformities. In addition, this paper will review the incidence, etiology, classification, and prognosis of spina bifida. The use of gait analysis and orthoses will be covered as well. The forthcoming Part II will cover foot and ankle deformities in spina bifida.

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Section: Hipmentioning

confidence: 99%

Section: Gait Analysismentioning

confidence: 99%

Section: Incidencementioning

confidence: 99%

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Orthopedic management of spina bifida. Part I: Hip, knee, and rotational deformities

Swaroop

Dias

2009

Journal of Children's Orthopaedics

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“…In a comparison of the functional results of the patients who had surgical reduction with those who did not, Feiwell et al [7] showed that surgical reduction neither reduced the need for brace nor improved hip ROM and mobility. Prior work suggests that muscle transfer surgery increases the energy consumption, and in unilateral hip instability, for symmetry, contracture release surgery has been proposed rather than joint reduction procedures [8]. Correll and Gabler [4] described that hip contracture release is a safe procedure with a low complication rate, which also permits early postoperative mobilization.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Hip Instability in Patients With Lower Lumbar Level Myelomeningocele: Is Muscle Transfer Required?

Yıldırım

Gürsu

Bayhan

et al. 2015

Clin Orthop Relat Res

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Background Treatment of hip instability in patients with lower lumbar level myelomeningocele is clinically challenging. Muscle transfer procedures, release of contractures, and intertrochanteric varus-rotation osteotomies have been described to restore weak or absent abductor strength as well as relocation of the hip. However, controlled trials evaluating hip instability in lower lumbar myelomeningocele are limited in the current literature. Questions/purposes The purposes of this study were to compare the (1) radiographic evidence for joint stability; (2) clinical outcomes (including abductor strength, ambulatory ability, and residual use of orthoses); and (3) complications between patients undergoing combined periarticular contracture releases and bony procedures with and without external oblique abdominal muscle transfers. Methods Between 2004 and 2013, 14 pediatric patients (16 hips) were treated for hip instability secondary to myelomeningocele using releases with or without muscle transfer. From those, 13 patients (15 hips) with a mean age of 6 years who had L3 to L5 level involvement were evaluated retrospectively. The patients were separated into two groups. Nine hips (in eight patients) were treated by performing a combination of external oblique abdominal muscle transfer to the greater trochanter, periarticular release of contractures, and bony procedures. These were compared with six hips (five patients) treated by performing a combination of periarticular release of contractures and bony procedures without external oblique abdominal muscle transfer. This study compared the results between two surgeons, one of whom always performed these muscle transfers in this setting and the other who never performed muscle transfer during the study period. The patients were clinically followed up at a mean of 41 months (range, 14-122 months); none of the patients was lost to followup. Radiographic evaluation criteria included Reimer's migration index, acetabular index, femoral neck-shaft angle, pelvic obliquity, and the presence of scoliosis. Clinical evaluation included muscle strength examination, periarticular contractures, necessity for using orthoses as walking aids, and Hoffer criteria of mobility. All complications were also noted from a chart review. Results There were no differences between the two groups regarding postoperative femoral head localization, reflecting the presence or absence of residual subluxation, according to Reimer's index (Reimer's index = 32%; range, 10%-40%, in the muscle transfer group compared Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each au...

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“…Kinematics and kinetics of the lower extremity during crutchassisted gait have been studied extensively in children with MM using 3-dimensional (3D) motion analysis (7)(8)(9)(10)(11). However, movements of the upper extremity (UE) (ie, thorax, shoulder, elbow, and wrist) during walking have only been investigated to a small extent in children with MM (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Upper Extremity Dynamics During Lofstrand Crutch-Assisted Gait in Children With Myelomeningocele

Slavens

Frantz

Sturm

et al. 2007

The Journal of Spinal Cord Medicine

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Gait Analysis in Low Lumbar Myelomeningocele Patients With Unilateral Hip Dislocation or Subluxation

Cited by 28 publications

References 30 publications

Orthopedic management of spina bifida. Part I: Hip, knee, and rotational deformities

Orthopedic management of spina bifida. Part I: Hip, knee, and rotational deformities

Surgical Treatment of Hip Instability in Patients With Lower Lumbar Level Myelomeningocele: Is Muscle Transfer Required?

Upper Extremity Dynamics During Lofstrand Crutch-Assisted Gait in Children With Myelomeningocele

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