The effect of obturator nerve block on hip lateralization in low functioning children with spastic cerebral palsy
Eun Sook Park1, Dong-Wook Rha, Won Chul Lee
1Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. eungeol@gmail.com.
Insights
Obturator nerve (ON) block effectively reduced hip lateralization in children with cerebral palsy (CP). This less invasive procedure prevented further hip displacement, offering a beneficial early intervention for spastic CP patients.
Area of Science:
- Pediatric Orthopedics
- Neurology
- Rehabilitation Medicine
Background:
- Hip adductor spasticity significantly contributes to hip displacement in children with cerebral palsy (CP).
- Obturator nerve (ON) block presents a less invasive alternative to surgery for managing hip adductor spasticity.
Purpose of the Study:
- To evaluate the efficacy of ON block in mitigating hip lateralization.
- To assess the impact of ON block on hip migration percentage (MP) in low-functioning children with spastic CP (GMFCS levels III-V).
Main Methods:
- Retrospective analysis of clinical and radiographic data from children with spastic CP and hip subluxation.
- Intervention group received ON block with 50% ethyl alcohol under electrical stimulation guidance.
- Migration percentage (MP) was measured and annual changes calculated for both intervention and non-intervention groups.
Main Results:
- The intervention group showed a significant reduction in MP at the first follow-up, with subsequent follow-ups maintaining initial levels.
- The non-intervention group exhibited a significant increase in MP at all follow-up points compared to baseline.
- Data included 49 legs (25 children) in the intervention group and 41 legs (23 children) in the non-intervention group.
Conclusions:
- Obturator nerve block with ethyl alcohol is an effective early intervention for progressive hip displacement in children with spastic CP.
- This procedure offers a valuable, less invasive option for managing hip adductor spasticity and its consequences.
Purpose:
Hip adductor spasticity has a great impact on developing hip displacement in children with cerebral palsy (CP). Obturator nerve (ON) block is less invasive intervention rather than soft tissue surgery for reduction of hip adductor spasticity. The aim of this study is to investigate the effect of ON block on hip lateralization in low functioning children with spastic CP.
Materials And Methods:
The study was performed by retrospective investigation of the clinical and radiographic follow-up data of low functioning children [gross motor function classification system (GMFCS) level III to V] with spastic cerebral palsy whose hip was subluxated. Migration percentage (MP) was measured on hip radiographs and its annual change was calculated. In intervention group, ON block was done with 50% ethyl alcohol under the guidance of electrical stimulation.
Results:
The data of 49 legs of 25 children for intervention group and the data of 41 legs of 23 children for nonintervention group were collected. In intervention group, the MP were significantly reduced at 1st follow-up and the MPs at 2nd and last follow-up did not show significant differences from initial MP. Whereas in nonintervention group, the MPs at 1st, 2nd and last follow-up were all significantly increased compared to initial MPs.
Conclusion:
ON block with ethyl alcohol is useful as an early effective procedure against progressive hip displacement in these children with spastic CP.
