Assessment of hip rotation after gait improvement surgery in cerebral palsy

Area of Science:

• Orthopedics
• Pediatric Neurology
• Rehabilitation Medicine

Background:

• Cerebral palsy (CP) frequently causes gait abnormalities, such as spastic internal rotation gait.
• Diplegic CP predominantly affects lower limbs, impacting mobility and quality of life.
• Surgical interventions aim to improve gait patterns and functional outcomes in children with CP.

Purpose of the Study:

• To evaluate the effectiveness of multi-level soft tissue surgery in correcting spastic internal rotation gait in children with diplegic cerebral palsy.
• To assess the long-term outcomes of surgical correction of dynamic rotational deformities.
• To determine if soft tissue surgery is beneficial in the absence of fixed bony deformities.

Main Methods:

• Gait analysis was performed on sixteen children with diplegic CP before and after surgery.
• All participants underwent multi-level soft tissue surgery, with medial hamstring lengthening as a consistent component.
• Follow-up evaluation occurred an average of 3 years post-surgery.

Main Results:

• Significant correction of the internal rotation gait was observed in the study cohort.
• Multi-level soft tissue surgery demonstrated effectiveness in addressing dynamic gait deviations.
• The positive outcomes were noted even in the presence of dynamic, rather than fixed, bony deformities.

Conclusions:

• Multi-level soft tissue surgery is an effective treatment for correcting spastic internal rotation gait in children with diplegic CP.
• Medial hamstring lengthening, as part of a multi-level approach, plays a key role in gait correction.
• This surgical strategy provides a viable option for improving gait in CP patients without fixed bony deformities.