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Soft tissue release of the spastic hip by psoas–rectus 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: July 2011 - Volume 20 - Issue 4 - p 212–221
doi: 10.1097/BPB.0b013e328344c529
Hip

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.

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.