Management of spastic lower extremities in cerebral palsy

Surgery in spastic lower extremities among cerebral palsy is reserved for patients with a reasonable chance to ambulate, to correct the spastic deformity and to improve gait. This study aims to assess the local results of various soft tissue operations such as adductor tenotomy, hamstring release, tendon of Achilles lengthening and tendon transfers. From December 1989 to January 1992, twenty one cerebral palsy children were included in this study. Preoperatively, two of these 21 patients were freely ambulatory. After surgery, 14 were free ambulators and 7 were crutch walkers. These results showed that soft tissue surgery is effective. Combined with intensive physical therapy, optimum ambulatory function of spastic cerebral palsy patients can be achieved. (Author)

Early results of supracondylar femoral osteotomy in severe knee flexion contractures in polio patients

Twenty one polio patients with severe knee flexion contractures admitted at the Santo Tomas University Hospital, Clinical Division from 1984 to 1990 were studied. There were 11 males and 10 females with age ranging from 12 to 18 years with a mean of 14.3 years. The degree of knee flexion ranged from 45 to 120 degrees with an average of 62.5 degrees. Clinical data included the ranges of motion, the stability of the hip, knee and ankle. Manual muscle testing as well as limb length and girth were recorded. the technique as described by Huckstep was conducted either as a one or two staged procedure with or without preliminary skeletal tractions. One patient required an internal fixation on the osteotomized fragments for stability. Two patients had residual flexion contracture of 5 ad 10 degrees after removal of cast. Only one patient abandoned her braces and opted to use her wheel chair despite healed osteotomy. (Author)