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Cerebral Palsy. Considerations Upon 249 Consecutive Patients and Review of Literature
S Bourgleh1, R N Nemeş2, B Hetaimish3
1"The First Clinic" Hospital, Jeddah, Kingdom of Saudi Arabia.
Insights
Cerebral palsy (CP) is a common orthopedic diagnosis. While treatments yield acceptable results, gait analysis can improve outcomes for children with CP.
Area of Science:
- Pediatric Orthopedics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a prevalent neurological disorder affecting children.
- Understanding the characteristics and treatment outcomes of CP is crucial for improving patient care.
Observation:
- A study analyzed 249 children with CP (0-12 years) in Jeddah, Saudi Arabia.
- The spastic type was predominant (92.8%), with spastic diplegia being most common (71.9%).
- Treatment involved conservative methods (42.2%) and surgery (59.8% indicated, 81 cases performed).
Findings:
- Postoperative results were acceptable in 93.8% of cases, with excellent outcomes in 2.4%.
- Recurrence and morbidity rates were 14.8% and 6.17%, respectively; no mortality was recorded.
- Treatment outcomes were not assessed in 51.9% due to lack of follow-up.
Implications:
- CP is the third most common diagnosis in pediatric orthopedic private practice.
- Current treatment results are acceptable but not optimal.
- Preoperative gait analysis may significantly enhance outcomes, particularly in complex CP cases.
Aim:
to determine the prevalence of cerebral palsy (C.P.) among children and to describe its main characteristics (clinical forms, treatment plan, and results).
Material And Methods:
249 C.P were studied (120 boys and 129 girls, aged between 0 and 12 years) during 2,321 consecutive clinic visits (incidence 10.7%) to a private pediatric orthopedic clinic in Jeddah, Saudi Arabia, between 2011 and 2016. Spastic type was the main clinical form (231=92.8%), spastic diplegia being the most frequent (166=71.9%). The treatment was complex: conservative only in 42.2%; surgery indicated in 149 (59.8%) cases was performed only in 81 cases, by means of muscle and/or bone procedures, depending on the lesion balance.
Results:
The postoperative results were excellent in 2.4% of cases, acceptable to some extent in 93.8% and poor in 3.8%. We registered a recurrence rate of 14.8%, a postoperative morbidity rate of 6.17% with a postoperative mortality rate of 0. Treatment results could not be assessed in 129 (51.9%) cases due to lack of follow up.
Conclusion:
1. C.P. represents the third most common diagnosis in pediatric orthopedic private practice. 2. The treatment results were acceptable in most cases, but not optimal. 3. Gait analysis using in the preoperative planning could improve significantly the outcome, especially in complicated cases.
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