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Pectoralis major release to improve shoulder abduction in children with cerebral palsy

Marcin Domzalski1, Muharrem Inan, Aaron G Littleton

  • 1Department of Orthopedics, Alfred I. duPont Hospital for Children, Wilmington, DE 19899, USA.

Journal of Pediatric Orthopedics
|May 22, 2007
PubMed

Insights

Pectoralis major muscle release surgery improved shoulder function and caregiver satisfaction in children with cerebral palsy, aiding in daily care tasks like bathing and dressing.

Area of Science:

  • Orthopedics
  • Pediatric Surgery
  • Rehabilitation Medicine

Background:

  • Cerebral palsy (CP) often leads to shoulder adduction contractures, impairing patient care.
  • These contractures significantly limit activities of daily living (ADLs) such as bathing and dressing.
  • Surgical intervention, like pectoralis major muscle release, is considered for severe cases.

Purpose of the Study:

  • To evaluate surgical outcomes of pectoralis major muscle release in pediatric CP patients.
  • To assess caregiver satisfaction with patient care post-surgery.
  • To identify specific indications and functional improvements following the procedure.

Main Methods:

  • Retrospective analysis of 21 shoulders in 13 CP patients (quadriplegic type predominant).
  • Surgical procedures included pectoralis release alone or combined with latissimus dorsi release.
  • Clinical examination and caregiver questionnaires assessed functional range of motion and satisfaction.

Main Results:

  • Passive abduction and flexion >90 degrees maintained in 10 patients.
  • External rotation remained restricted in 6 patients.
  • Caregivers reported significant improvement in patient care and overwhelmingly recommended the surgery.

Conclusions:

  • Pectoralis major muscle release is indicated for CP patients with shoulder adduction contractures impacting custodial care.
  • The procedure effectively improves shoulder mobility, facilitating essential hygiene and dressing.
  • High caregiver satisfaction underscores the functional benefits for patients with severe CP.

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