title: Soft tissue release of the spastic hip by psoas-rectus transfer and adductor tenotomy for long-term functional improvement and prevention of hip dislocation.
abstract: The purpose of this study was to assess the long-term development of children with cerebral palsy treated with soft tissue releases of the hip and, if necessary, also of the hamstrings and the Achilles tendon. The follow-up had to consider the functional status and the hip centration. Seventy-one patients (46 with tetrapareses, 24 with dipareses, and one with triparesis) who underwent soft tissue releases of the hip by the so-called psoas-rectus transfer at an average age of 7 years were assessed preoperatively, after 1 year and at an average age of 19 years. Functional status and the radiological lapse were assigned. The functional status of the patients significantly improved (P<0.001) after surgery. The number of patients who were able to walk increased from 49.3 to 80.3%. The migration percentage decreased from 26.6 to 17.3%. For medium-to-severe functional deficits, a clear gain of function and a safe prevention of spastic hip luxation were achieved.
authors.affiliation: aDepartment of Orthopedic Surgery, Pediatric Orthopedic Unit, Campus Großhadern, Ludwig Maximilians University, Marchioninistraße 15, Munich, Germany. bernhard.heimkes@med.uni-muenchen.de
authors.forename: Bernhard
authors.initials: B
authors.lastname: Heimkes
authors.forename: Kathrin
authors.initials: K
authors.lastname: Martignoni
authors.forename: Sandra
authors.initials: S
authors.lastname: Utzschneider
authors.forename: Siegfried
authors.initials: S
authors.lastname: Stotz
mesh_terms: D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006617:Hip Dislocation / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D008297:Male; D009128:Muscle Spasticity; D019637:Orthopedic Procedures; D016658:Psoas Muscles / Q000601:surgery*; D052097:Quadriceps Muscle / Q000601:surgery*; D013524:Surgical Flaps; D013710:Tendons / Q000601:surgery*