Soft-tissue Releases to Treat Spastic Hip Subluxation in Children with Cerebral Palsy: Effect of Age at the Time of Surgery / The Japanese Journal of Rehabilitation Medicine

ABSTRACT

Objectives: Muscle imbalance poses a problem for adequate motor function in patients with cerebral palsy. The adductor and flexor muscles around the hip become dominant, leading to a high risk of hip dislocation. When left untreated, flexion and adduction contracture progresses, leading to various impairments ; hence, it is important to undertake preventive measures at an early stage. Selective muscle release is one form of surgical treatment that has been proven effective, but there is no consensus on the timing of the surgery. Here, we investigated the difference in outcome after muscle release surgery with respect to age. Subjects and methods: The subjects were 26 patients (52 hips) from our medical center who underwent muscle release (partial modification of Matsuo's method) around the hip and were followed up for at least 6 months. Abduction was retained postoperatively by using a cast or prosthetic device. Migration percentage (MP) was measured by simple hip radiography image, and the rates of improvement (preoperative MP . final MP during observation/preoperative MP ×100%) were compared. Results: Higher rates of improvement were observed among patients aged 5 years or less at the time of surgery than those among patients aged 6 years or more. Conclusion: We consider that surgery performed at the age of 5 years or less could lead to favorable results.