You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Soft tissue release of the spastic hip by psoasrectus transfer and adductor tenotomy for long-term functional improvement and prevention of hip dislocation

Heimkes, Bernharda; Martignoni, Kathrina; Utzschneider, Sandraa; Stotz, Siegfriedb

Journal of Pediatric Orthopaedics B:
doi: 10.1097/BPB.0b013e328344c529
Hip
Abstract

The purpose of this study was to assess the long-term development of children with cerebral palsy treated with soft tissue releases of the hip and, if necessary, also of the hamstrings and the Achilles tendon. The follow-up had to consider the functional status and the hip centration. Seventy-one patients (46 with tetrapareses, 24 with dipareses, and one with triparesis) who underwent soft tissue releases of the hip by the so-called psoas–rectus transfer at an average age of 7 years were assessed preoperatively, after 1 year and at an average age of 19 years. Functional status and the radiological lapse were assigned. The functional status of the patients significantly improved (P<0.001) after surgery. The number of patients who were able to walk increased from 49.3 to 80.3%. The migration percentage decreased from 26.6 to 17.3%. For medium-to-severe functional deficits, a clear gain of function and a safe prevention of spastic hip luxation were achieved.

Author Information

aDepartment of Orthopedic Surgery, Pediatric Orthopedic Unit, Campus Großhadern, Ludwig Maximilians University

bEmeritus, formerly: Spastiker-Zentrum (ICP) München, Munich, Germany

Correspondence to Bernhard Heimkes, MD, Department of Orthopedic Surgery, Klinikum Großhadern, Ludwig-Maximilians-Universität, Marchioninistraße 15, München 81377, Germany Tel: +49 89 7095 3920; fax: +49 89 7095 3934; e-mail: bernhard.heimkes@med.uni-muenchen.de

© 2011 Lippincott Williams & Wilkins, Inc.