Effect of distal hamstring release on cerebral palsy patients

Thirty patients had distal hamstring release with modified Green technique: 21 spastic diplegics, 8 spastic quadriplegics, and 1 spastic hemiplegic. The average age at the time of surgery was 6.9 years. The average follow-up was 2.5 years. Average improvement of 40 degrees in the popliteal angle was noted at follow-up. Twenty-three patients improved their gait pattern. Nine patients improved one level of walking ability. A popliteal angle over 50 degrees was defined as recurrent. On the basis of this criterion, the recurrence rate was 12.5% (7/56 knees). In all recurrent cases, however, the tightness was less severe than preoperatively. Noncompliance on the part of parents was the chief reason for recurrence. Distal hamstring release is an effective procedure in treatment of cerebral palsy patients with flexion deformity.