Use of Serial Casting in the Management of Knee Joint Contractures in an Adolescent with Cerebral Palsy

Abstract

Treatment of adolescents with cerebral palsy often presents clinical problems that differ from those encountered when treating younger children with cerebral palsy. Muscle contractures, which may not yield to traditional therapeutic exercise, may be a problem. The purpose of this case report is to describe the use of serial casting in the treatment of knee joint flexion contractures in an adolescent with cerebral palsy.

Treatment of Knee Flexion Contracture Due to Central Nervous System Disorders in Adults

“…The functional impact can be considerable, altering the quality of life and the autonomy of these patients [4][5][6][7] . Surgical treatment of musculoskeletal complications of cerebral palsy in children has been the focus of many studies [8][9][10][11][12][13][14][15] . Studies of muscle contractures, particularly flexion contractures of the knee, in adult patients with neurological disorders are rare.…”

Managing Flexion Knee Deformity Using a Circular Frame

“…For severe knee deformity, knee disarticulation and prosthetic fitting were the most effective treatments [21]. Amputation is not an acceptable solution in our culture.…”

Effect of serial casting in spastic cerebral palsy

“…(Table 4) Serial casting for progressive correction was applied for all three major joints simultaneously in most of the children in our study. Except for one case report of knee flexion contracture, 25 all other studies included children with either equinus 9, 11-24 or equinus deformity with mild involvement of hip and knee. 10 Conservative management of scissoring was also not considered in these studies.…”

“…But a case of adolescent CP who was operated previously for equinus deformity and presented with flexion, contracture at knee was reported for reduction of contracture and increase in range of motion around knee by serial casting. 25 Present study was conducted to evaluate the effect of serial casting in spastic children in terms of increase in range of motion, reduction of spasticity and improvement in ambulation in whom all three major joints (hip, knee and ankle) were involved.…”