PURPOSE: The purpose of this study was to evaluate the results of distal femur extension osteotomy and medial hamstring lengthening in the treatment of fixed knee flexion deformity in patients with spastic diparetic cerebral palsy. METHODS: A retrospective study was done in a group of 12 diparetic cerebral palsy patients. A distal femur extension osteotomy was performed as part of multilevel surgery on lower limbs. The fixed knee flexion deformity was measured during physical examination, whereas hip and knee flexion in the stance phase and anterior pelvic tilt were both analyzed at kinematics. The pre- and post-surgery results were compared and analyzed statistically. A medical record review was done in order to identify the complications. The mean follow-up was 28 months. RESULTS: A significant reduction of fixed knee flexion deformity at physical examination and knee flexion in the stance phase at kinematics was observed, but with no decrease in hip flexion. As a non-desired effect, there was an increase in anterior pelvic tilt after surgical procedures. With regard to complications, a single patient had skin breakdown at a calcaneous area on one side and the recurrence of deformity was seen in 27% of cases. CONCLUSIONS: In this study, in which fixed knee flexion deformity did not exceed 40 degrees before surgery, the distal femur extension osteotomy was effective in increasing knee extension in the stance phase. However, an increase in anterior pelvic tilt, deformity recurrence and necessity for walking aids are possible complications of this procedure.
PURPOSE: The purpose of this study was to evaluate the results of distal femur extension osteotomy and medial hamstring lengthening in the treatment of fixed knee flexion deformity in patients with spastic diparetic cerebral palsy. METHODS: A retrospective study was done in a group of 12 diparetic cerebral palsypatients. A distal femur extension osteotomy was performed as part of multilevel surgery on lower limbs. The fixed knee flexion deformity was measured during physical examination, whereas hip and knee flexion in the stance phase and anterior pelvic tilt were both analyzed at kinematics. The pre- and post-surgery results were compared and analyzed statistically. A medical record review was done in order to identify the complications. The mean follow-up was 28 months. RESULTS: A significant reduction of fixed knee flexion deformity at physical examination and knee flexion in the stance phase at kinematics was observed, but with no decrease in hip flexion. As a non-desired effect, there was an increase in anterior pelvic tilt after surgical procedures. With regard to complications, a single patient had skin breakdown at a calcaneous area on one side and the recurrence of deformity was seen in 27% of cases. CONCLUSIONS: In this study, in which fixed knee flexion deformity did not exceed 40 degrees before surgery, the distal femur extension osteotomy was effective in increasing knee extension in the stance phase. However, an increase in anterior pelvic tilt, deformity recurrence and necessity for walking aids are possible complications of this procedure.
Authors: David E Westberry; Jon R Davids; Jeannine M Jacobs; Linda I Pugh; Stephanie L Tanner Journal: J Pediatr Orthop Date: 2006 Jan-Feb Impact factor: 2.324
Authors: Alexander S Spiro; Peggy Stenger; Michael Hoffmann; Eik Vettorazzi; Kornelia Babin; Sandra Lipovac; Jan Philipp Kolb; Alexander Novo de Oliveira; Johannes M Rueger; Ralf Stuecker Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-02-04 Impact factor: 4.342
Authors: Matthias C M Klotz; Klemens Hirsch; Daniel Heitzmann; Michael W Maier; Sebastien Hagmann; Thomas Dreher Journal: World J Pediatr Date: 2016-12-23 Impact factor: 2.764
Authors: Young Choi; Sang Hyeong Lee; Chin Youb Chung; Moon Seok Park; Kyoung Min Lee; Ki Hyuk Sung; Sung Hun Won; In Hyeok Lee; In Ho Choi; Tae-Joon Cho; Won Joon Yoo; Seung Yeol Lee Journal: Clin Orthop Surg Date: 2014-11-10