A randomized controlled trial of early surgery in Duchenne muscular dystrophy.
We performed a randomized controlled trial of early surgical treatment of contractures in 20 boys with Duchenne muscular dystrophy, age 4-6 yr. Surgery consisted of release of hip flexors, removal of iliotibial bands, and lengthening of tendo Achilles bilaterally. All patients were monitored for at least 12 months post-randomization, and assessed quantitatively for muscle strength and function. Surgery corrected the deformities, but had no beneficial effect on strength or function. Indeed, data in the second year showed more rapid deterioration of function in some of the operated boys. There appeared to be continued evolution of pathology following surgery, as assessed by sequential muscle ultrasound and muscle biopsy. We cannot recommend this type of surgery as a routine treatment.
Manzur
A Y
AY
Hammersmith Neuromuscular Centre, Department of Paediatrics, Royal Postgraduate Medical School, London, U.K.
Hyde
S A
SA
Rodillo
E
E
Heckmatt
J Z
JZ
Bentley
G
G
Dubowitz
V
V
D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D005684:Gait; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D009132:Muscles / Q000000981:diagnostic imaging / Q000473:pathology; D009136:Muscular Dystrophies / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012044:Regression Analysis; D014463:Ultrasonography