Treatment of spastic diplegia in patients with cerebral palsy: Part II

Aiona, Michael D.; Sussman, Michael D.

doi:10.1097/00009957-200405000-00016

Cited by 33 publications

(18 citation statements)

References 98 publications

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“…SEMLS is not a uniform procedure but is tailored to the child's needs and includes realigning bony levers, lengthening or transferring muscle-tendon units. 1 It has been demonstrated that SEMLS corrects musculoskeletal pathology and can significantly improve the gait pattern. 2,3 Most reports have described gait-related outcomes from the body structure and function domain.…”

mentioning

confidence: 99%

Evolution of self‐care and functional mobility after single‐event multilevel surgery in children and adolescents with spastic diplegic cerebral palsy

Dequeker

Campenhout

Feys

et al. 2018

Develop Med Child Neuro

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mentioning

confidence: 99%

Evolution of self‐care and functional mobility after single‐event multilevel surgery in children and adolescents with spastic diplegic cerebral palsy

Dequeker

Campenhout

Feys

et al. 2018

Develop Med Child Neuro

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“…Aiona and Sussman [4] believed that the natural history of the spastic flatfoot begins with unbalanced muscles’ strength besides the subtalar joints, then contracture of the muscles causes skeletal changes like heel valgus and lateral displacement of the calcaneus. Upon further progression, secondary skeletal developmental malformation occurs complicated with osteoarthritis of the talocalcaneal joint, the talonavicular joint, and the metatarsophalangeal joint, thereby completely losing the potential of spontaneous relief.…”

Section: Introductionmentioning

confidence: 99%

“…Conservative treatments [4] include the use of insole, ankle-foot orthosis (AFO), and the use of assistive devices. Botulinum injection and baclofen pump therapy have also been tried.…”

Section: Introductionmentioning

confidence: 99%

Comparison of mid-term efficacy of spastic flatfoot in ambulant children with cerebral palsy by 2 different methods

Wen

Liu²,

Xiao³

et al. 2017

Medicine

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To compare the treatment efficacy of spastic flatfoot surgery by 2 different surgical methods: nonfusion subtalar arthroereisis using subtalar joint stabilizer (SJS) and Dennyson–Fulford subtalar arthrodesis (D-FSA).A total of 26 cases of ambulant children with cerebral palsy diagnosed as spastic flatfoot were surgically treated from January 2011 to December 2014. Preoperative and postoperative American Orthopedic Foot and Ankle Society-Ankle and Hindfoot (AOFAS-AH) scores, anteroposterior–talocalcaneal angles (ATAs), and lateral talar-first metatarsal angles (Meary angles) of the affected foot were recorded.Among 12 children in the SJS group, the AOFAS-AH scores were median preoperative score of 61 (58–64) versus median postoperative score of 83 (75–92), with significant difference (P < .05). Of the 20 feet treated, only 1 foot developed occasional pain. Postoperative ATA was decreased from preoperative 35° (20°–50°) to 19° (12°–25°); lateral X-ray films showed that the Meary angle was decreased from preoperative 20° (15°–40°) to postoperative 0° (0°–3°). The differences in both findings were statistically significant (P < .05). Fourteen children (22 treated feet) formed the D-FSA group; all demonstrated fusion of the talocalcaneal joint; AOFAS-AH scores were median preoperative score of 61 (58–64) versus median postoperative score of 83 (75–92), with significant difference (P < .05). Only 1 foot had occasional pain. Postoperative ATA was decreased from preoperative 35° (20°–45°) to 16° (12°–25°); lateral X-ray films showed that the Meary angle was decreased from preoperative 19° (10°–40°) to postoperative 2° (0°–5°); the differences in both findings were statistically significant (P < .05).Both nonfusion subtalar arthroereisis using SJS and D-FSA were effective for the surgical treatment of spastic flatfoot, with similar clinical outcomes.

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“…Подход к оперативному лечению ортопедических осложнений ЦП заключается в выполнении многоуровневых одномоментных оперативных вмешательств [1,8,14,23,24,29,30]. В нашей серии 119 (87,5%) стоп имели вальгусную девиацию.…”

Section: Discussionunclassified

Correction of Foot Deformities using Triple Arthrodesis and Its Effect on Soft Tissue Blood Supply at Surgical Site in Patients with Cerebral Palsy

Leonchuk

Щурова

Popkov

et al. 2018

Traumatology and Orthopedics of Russia

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The aim of the studyis to evaluate the efficiency of triple arthrodesis of foot and its effect on soft tissues blood supply at the surgical site during simultaneous correction of segment deformity in patients with cerebral palsy.Material and Methods. The present study reflects the authors’ experience of triple arthrodesis for correction and stabilization of foot multicomponent deformities of varying severity in 75 patients (136 feet) with cerebral palsy (IIIV level by Gross Motor Function Classification System (GMFCS)) treated in the Ilizarov center in the period from April 2012 to December 2016. The average age of the patients was 16.4±4.3 years (from 11 years 8 months to 43 years 3 months). All patients included into the study had severe arthrosis of hind and midfoot. The main option of foot fixation in this group of patients was internal fixation (elastic threaded wires, compression screws) together with plaster cast immobilization for 6–8 weeks. All patients underwent average of 4.59 surgical elements during a procedure as part of simultaneous multilevel interventions. The blood supply at the surgical site was evaluated by laser and high-frequency Doppler flowmetry before and after all stages of the surgery.Results.Long-term outcomes were evaluated at the average of 19 months after the surgery in 56 (74.7%) patients. 37 patients (66.1%) demonstrated good treatment outcomes and 19 patients (33.9%) — satisfactory outcomes. No unsatisfactory outcomes were observed. The clinical outcome of foot surgery was evaluated using the Angus-Cowell criteria. The obtained significant x-ray enhancement was maintained at the control stages of the follow up. Despite large simultaneous correction of foot deformity, there was no decrease in the parameters of microcirculatory blood supply of the skin, muscles and subcutaneous fat of the foot. The authors observed a stabilized or an increased perfusion of soft tissues.Conclusion.Triple arthrodesis for correction of foot deformities in patients with cerebral palsy and severe arthrosis in hind and midfoot is an efficient method which allows to correct and stabilize gained position of segments. The data of physiological research testify the sparing approach of such procedure and a possibility of an earlier weight-bearing on operated limb.

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Treatment of spastic diplegia in patients with cerebral palsy: Part II

Cited by 33 publications

References 98 publications

Evolution of self‐care and functional mobility after single‐event multilevel surgery in children and adolescents with spastic diplegic cerebral palsy

Evolution of self‐care and functional mobility after single‐event multilevel surgery in children and adolescents with spastic diplegic cerebral palsy

Comparison of mid-term efficacy of spastic flatfoot in ambulant children with cerebral palsy by 2 different methods

Correction of Foot Deformities using Triple Arthrodesis and Its Effect on Soft Tissue Blood Supply at Surgical Site in Patients with Cerebral Palsy

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