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Lower extremity surgery in muscular dystrophy.

J Griffet¹, L Decrocq, H Rauscent

¹Pediatric Surgery Department, Parental Couple-Child Hospital, BP 217, 38043 Grenoble cedex 09, France. jgriffet@chu-grenoble.fr

Orthopaedics & Traumatology, Surgery & Research : OTSR

|September 20, 2011

Summary

Tendon surgery effectively releases hip and ankle contractures in children with neuromuscular diseases. While knee surgery offers limited benefits, hip and ankle procedures improve positioning and can slow scoliosis progression.

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Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy

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Published on: January 12, 2019

Area of Science:

Orthopedic Surgery
Pediatric Orthopedics
Neuromuscular Diseases

Background:

Neuromuscular diseases often lead to progressive musculotendinous contractures, impacting mobility.
Early treatment may not prevent contractures, necessitating surgical intervention.

Purpose of the Study:

To evaluate the effectiveness of tendon surgery in correcting contractures in children with neuromuscular diseases.
To assess the long-term outcomes of hip, knee, and ankle surgery for contracture release.

Main Methods:

Twenty children with muscular dystrophy underwent hip, knee, and/or ankle surgery.
Procedures included tenectomies, tenotomies, tendon lengthening, and posterior tibial tendon transfer.
Range of motion was assessed preoperatively and up to 7.4 years post-surgery.

Main Results:

Significant improvements were observed in hip extension and adduction contractures.
Knee flessum showed only slight improvement, with regression noted.
Ankle equinus deformity was corrected, and posterior tibial tendon transfer improved varus correction.
Surgery enabled continued device-assisted upright positioning for a mean of 3 years.

Conclusions:

Hip and ankle surgery effectively release contractures in neuromuscular disease patients.
Knee surgery is recommended only for severe knee flessum (>30°).
Extensive tensor fascia lata tenectomy and posterior tibial tendon transfer yield optimal results.
Surgery is indicated for severe contractures, aiming to improve positioning rather than restore walking ability.