What’s New in the Orthopaedic Treatment of Cerebral Palsy

Aversano, Michael W.; Taha, Abdel Majid Sheikh; Mundluru, Surya; Otsuka, Norman Y.

doi:10.1097/bpo.0000000000000675

Cited by 10 publications

(8 citation statements)

References 33 publications

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“…Limb deformities due to individual diseases such as poliomyelitis and cerebral palsy have been studied by previous authors [ 2 – 4 , 6 ], few have organized these diseases into a category for summary and study [ 1 ]. In this study, the characteristics of 30,194 NLDD patients treated surgically between 1979 and 2019 based on the QSHOSCD were statistically analyzed.…”

Section: Discussionmentioning

confidence: 99%

“…Neurogenic limb deformity disorder (NLDD) refers to limb deformity disorders caused by various neurogenic diseases, and we propose this concept for the first time. Currently there are relatively few studies on NLDD [ 1 ], these studies are mainly summary analyses of individual disorders, such as polio [ 2 , 3 ] and cerebral palsy [ 4 – 6 ]. In China, no studies have reported on the epidemiological characteristics of NLDD.…”

Section: Introductionmentioning

confidence: 99%

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The epidemiological characteristics of neurogenic limb deformity disorder in China: a national-based study from Qin Sihe orthopedic center

Liu

Guan²,

Zang

et al. 2023

BMC Public Health

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Background Neurogenic limb deformity disorder (NLDD) refers to limb deformity disorders caused by various neurogenic disorders. However, there are no studies to systematically summarize and analyze these diseases in China, and we first proposed the concept of NLDD. We describe the epidemiological characteristics of NLDD in China based on the largest case database of limb orthopedics in China. Methods This study analyzed parameters from the Qin Sihe Orthopedic Surgery Case Data (QSHOSCD). The database is based on the Rehabilitation Hospital affiliated to National Research Center for Rehabilitation, which has collected nearly 37,000 patients to date and includes a wide variety of limb deformities. The types of diseases are summarized and classified for all patients studied. Statistical analysis was based on the type of etiology, age, regional distribution, and historical surgical volume. Partial outcomes were statistically analyzed separately by common diseases (polio and cerebral palsy) and rare diseases (37 other diseases). Results From 1979 to 2019, 30,194 patients with NLDD were treated surgically for 39 neurogenic disorders. The male to female ratio was 1.48:1, the mean age was 19.65 years, and most patients (82.38%) were aged between 6 and 30 years. Patients included from 32 provinces and cities across China, mainly concentrated in populous central provinces and Heilongjiang Province. The peak of annual surgical procedures was from 1988 to 1994, and the number of annual surgical procedures for common diseases gradually decreased from 1994 onwards, but the trending is opposite for rare diseases. Conclusions This study is the first to demonstrate the disease types, population characteristics and incidence trends of NLDD in China. It suggests that the prevention and treatment of NLDD should focus on the adolescent population and enhance the treatment of neurogenic diseases that cause limb deformities. The growth and adaption of the Ilizarov technique and its practice in Chinese orthopedic benefits the treatment of neurogenic limb deformity disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The epidemiological characteristics of neurogenic limb deformity disorder in China: a national-based study from Qin Sihe orthopedic center

Liu

Guan²,

Zang

et al. 2023

BMC Public Health

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“…The risk profile for complications, including unintended fractures, is derived from the pediatric orthopedic literature reviews on treating patients with cerebral palsy. 10 , 11 Surgical techniques to minimize the risk profile are discussed next.…”

Section: Methodsmentioning

confidence: 99%

SPINE: An Initiative to Reduce Pressure Sore Recurrence

Brown

Hassanein

Gabriel

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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The recurrence rate after pressure sore reconstruction remains high. Primary inciting factors can be organized into efforts aimed at wound prevention: spasticity relief, pressure off-loading, infection and contamination prevention, nutrition optimization, and maximizing extremity function. This article presents our detailed protocol, SPINE, to address each inciting factor with a summary of cases at our facility and review best practices from evidence-based medicine in the literature.

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“…Можно полностью согласиться с M. W. Aversano и соавт. [67] в том, что понимание ортопедического лечения детей с ДЦП продолжает расти и расширяться, но до настоящего времени существует небольшое количество работ с высокой степенью доказательности, поэтому данное направление исследования является одним из приоритетных в детской ортопедии.…”

Section: выводыunclassified

Correction of hip joint instability in children with cerebral palsy — current state of the problem and prospects for its solution (literature REVIEW)

Sakalouski¹,

Herasimenka²,

Klimau³

et al. 2021

OTP

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Hip instability in children with cerebral palsy (CP) is a serious unresolved problem in modern orthopedics. Objective. To analyze the state of the problem of the hip joint instability in children with cerebral palsy and determine the prospects for its solution. Methods. A thematic review of 68 studies was made. Results. The basis for the prevention of instability of the hip joint should be a systematic X-ray screening at least once a year. The instability of the hip joint is based on neurological disorders, if the index of migration of the femoral head (MP) is less than 30 %, the application of selective dorsal rhizotomy or baclofen pump is promising and justified. If MP > 30–100 % dorsal rhizotomy can be used after surgical correction of abnormalities in the hip joint to reduce the recurrence rate. The existing surgeries on the pelvic and femur is sufficient to restore the stability of this joint, even in the most severe cases, but the result is not always possible to maintain due to the recurrence of the deformity. The requirement for hip intervention in a patient with cerebral palsy is a preventive focus, by which we mean not only the achievement of joint stability, but also the creation of conditions for its preservation. Temporary blockage of the medial portion of the femoral head growth area is a minimally invasive procedure and may be recommended for use alone or as an adjunct to hip soft tissue release or for hip and bone surgery. However, it is still unclear at what age it is better to block the growth plate of the femoral head, whether and how often to change the clamps and so on. A prerequisite for the treatment of patients with this pathology is an individual approach, taking into account the degree of displacement of the femoral head, the presence of pathology of adjacent joints, the age of the child and the severity of the disease. Correction of existing deviations should be performed in one step at many levels.

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What’s New in the Orthopaedic Treatment of Cerebral Palsy

Abstract: Level 4-literature review.

Cited by 10 publications

References 33 publications

The epidemiological characteristics of neurogenic limb deformity disorder in China: a national-based study from Qin Sihe orthopedic center

The epidemiological characteristics of neurogenic limb deformity disorder in China: a national-based study from Qin Sihe orthopedic center

SPINE: An Initiative to Reduce Pressure Sore Recurrence

Correction of hip joint instability in children with cerebral palsy — current state of the problem and prospects for its solution (literature REVIEW)

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