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Z Orthop Ihre Grenzgeb. 1975 Apr;113(2):181-8.

[Results of surgical correction of flexion contractures of the knee joint in CP children (author's transl)].

[Article in German]

Abstract

Follow-up of 78 CP children with elongation of the tendons of knee flexors. In addition further operations were done in a large number of cases, frequently shortening of the patellar ligament, lengthening of hip flexors and correction of pes equinus. The further motor development shows worsening in 8, no improvement in 28 and improvement in 42 children. Analysis according to age showed better results in children under 9 years: Of the 48 younger children 33 showed progress, 13 free walking. Of the 30 older children only 9 showed progress and only 2 learned to walk freely. This difference was significant. Investigation of the causes for not walking showed the importance of motor preconditioning. Only children who had knee-standing before operation learned free walking. Major lack of motor development was most frequently preventing walking. Further causes were mental retardation, athetosis, pes calcaneus and general flexion patterns. While results in gaining extension at the knee were quite good, outward rotation at the hip averaged an improvement of 9.7 degrees. A favorable influence of combined elongation of knee flexors and adductor tenotomy at the hip in the CE angle was also clear. It diminished on average by 6.9 degrees. Special pre-operative conditions and the technique of examination are discussed in detail.

PMID:
1136549
[Indexed for MEDLINE]

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