Anterior elbow release of spastic elbow flexion deformity in children with cerebral palsy

Area of Science:

• Orthopedic Surgery
• Pediatric Neurology
• Rehabilitation Medicine

Background:

• Cerebral palsy (CP) often causes spastic elbow flexion deformity, limiting upper limb function.
• This condition significantly impacts daily activities and quality of life for affected children.
• Effective surgical interventions are crucial for managing spasticity in CP.

Purpose of the Study:

• To evaluate the efficacy of anterior elbow release surgery for treating spastic elbow flexion deformity in children with cerebral palsy.
• To assess the impact of the surgical procedure on key functional outcomes and patient-reported measures.

Main Methods:

• A consecutive series of 42 anterior elbow release procedures in 40 children with CP were analyzed.
• The surgical technique involved releasing the lacertus fibrosus, lengthening the brachialis aponeurosis, and denuding the biceps tendon.
• Preoperative and postoperative assessments included range of motion, functional arm use, and parental questionnaires.

Main Results:

• Significant improvement in flexion posture angle (average reduction of 49 degrees) and active elbow extension (improved from 43 to 27 degrees).
• No significant change was observed in active elbow flexion.
• Mean percentage of arm use increased substantially from 12% preoperatively to 44% postoperatively.

Conclusions:

• Anterior elbow release is an effective surgical option for improving elbow posture and extension in children with CP.
• The procedure leads to significant gains in functional arm use and potentially improves the aesthetic appearance of the limb.
• This intervention offers a valuable therapeutic approach for managing spastic elbow flexion deformity in pediatric CP patients.