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Published on: August 9, 2024
RESULTS OF ADDUCTORS MUSCLE TENOTOMY IN SPASTIC CEREBRAL PALSY
Luiz Gabriel Betoni Guglielmetti1, Ruy Mesquita Maranhao Santos1, Rodrigo Góes Medea de Mendonça1
1Resident Physicians in the Department of Orthopedics and Traumatology, Santa Casa School of Medical Sciences, "Femandinho Simonsen" Wing, Santa Casa de Mise-ricórdia de São Paulo.
Objective:
Radiographic evaluation of the evolution of hips that underwent soft-tissue release.
Methods:
This was a retrospective evaluation on 101 spastic cerebral palsy patients who underwent soft-tissue release between 1991 and 2006. Forty-four patients met the inclusion criteria: 23 boys and 21 girls; 34 diparetic and 10 quadriparetic. Functionally, 29 were non-walkers, five were able to walk at home and 10 were able to walk within the community. Reimers' index (RI) and the acetabular index (AI) were measured on pre and postoperative radiographs, with a minimum follow-up of three years. The mean age at the time of surgery was 6.4 years.
Results:
The results were considered good if the RI had reduced, or had increased by less than 10%. This was found in 52% of this study. We observed a clear improvement in IR, along with worse results in patients with more than five years of postoperative follow-up.
Conclusion:
Soft-tissue release should be performed as early as possible, regardless of age, walking condition, clinical type, RI, AI or sex, and as soon as the patient clinically presents less than 30° abduction, because of the benefits relating to walking, prevention and treatment of subluxation, hygiene and pain relief.
