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Cerebral palsy surgery

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https://www.readbyqxmd.com/read/28443277/pediatric-hand-surgery-training-in-nicaragua-a-sustainable-model-of-surgical-education-in-a-resource-poor-environment
#1
Mary Claire B Manske, Jairo J Rios Roque, Gabriel Ramos Zelaya, Michelle A James
Recent reports have demonstrated that nearly two-thirds of the world's population do not have access to adequate surgical care, a burden that is borne disproportionately by residents of resource-poor countries. Although the reasons for limited access to surgical care are complex and multi-factorial, among the most substantial barriers is the lack of trained surgical providers. This is particularly true in surgical subspecialties that focus on life-improving, rather than life-saving, treatments, such as pediatric hand and upper extremity surgery, which manages such conditions as congenital malformations, trauma and post-traumatic deformities including burns, and neuromuscular conditions (brachial plexus birth palsy, spinal cord injury, and cerebral palsy)...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28439304/is-percutaneous-medial-hamstring-myofascial-lengthening-as-anatomically-effective-and-safe-as-the-open-procedure
#2
T Mansour, J Derienne, M Daher, D Sarraf, Y Zoghbi, I Ghanem
BACKGROUND: Medial hamstring fractional lengthening is commonly performed in children with cerebral palsy (CP) to decrease contracture and/or to improve gait. Percutaneous procedures are gaining more and more popularity, even in the paediatric population, with equivocal results. The purpose of this paper was to determine the efficacy and safety of percutaneous medial hamstring myofascial lengthening (PHL). METHODS: This is a prospective randomised controlled trial including 31 knees from 18 consecutive patients with CP scheduled for medial hamstring lengthening in the setting of multilevel tendon lengthening procedures in a university hospital...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28437759/correlation-of-technical-surgical-goals-to-the-gdi-and-investigation-of-post-operative-gdi-change-in-children-with-cerebral-palsy
#3
Christina Bickley, Judi Linton, Nancy Scarborough, Elroy Sullivan, Katy Mitchell, Douglas Barnes
AIM: The purpose of this study was to introduce a standardized set of surgical technical achievement goals (TAGs) as part of a comprehensive outcome assessment model for children with spastic cerebral palsy (CP) undergoing orthopaedic surgical intervention to improve gait. Examination of relationships of these surgical goals to the Gait Deviation Index (GDI) and use of two assessments in tandem provided a thorough picture of technical surgical outcomes. This study also investigated changes in GDI in children with spastic CP after surgery...
April 13, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28431256/neurodevelopmental-outcomes-of-neonates-undergoing-surgery-under-general-anesthesia-for-malrotation-of-intestines
#4
Suresh Birajdar, Shripada Rao, Judy McMichael
BACKGROUND: It is difficult to differentiate between the potential adverse effects of general anesthesia (GA) on the developing brain and the role of associated co-morbidities and syndromes that can adversely affect neurodevelopmental outcomes in neonates undergoing GA. Neonates with malrotation of the intestines without volvulus usually do not have co-morbidities or syndromes. In addition, majority of them recover very well after surgery and are discharged home within a few days. Neonates with malrotation are a clean cohort of babies to study the role of a single episode of GA on the developing brain...
April 18, 2017: Early Human Development
https://www.readbyqxmd.com/read/28401027/beneficial-effects-of-childhood-selective-dorsal-rhizotomy-in-adulthood
#5
T S Park, Caleb Edwards, Jenny L Liu, Deanna M Walter, Matthew B Dobbs
 Selective dorsal rhizotomy (SDR) has been used to treat children with spastic cerebral palsy (CP) for over three decades. However, little is known about the outcomes of childhood SDR in adults.  Objectives: 1) To study the effects of childhood SDR on the quality of life and ambulatory function in adult life. 2) To determine late side effects of SDR in adults.   Methods: Adults (> 17.9 years) who underwent SDR in childhood (2 - 17.9 years) between 1987 and 2013 were surveyed in 2015. Patients completed a survey, including questions on demographic information, quality of life, health, surgical outcomes, motor function, manual ability, pain, braces/orthotics, post-SDR treatment, living situation, education level, work status, and side effects of SDR...
March 5, 2017: Curēus
https://www.readbyqxmd.com/read/28395573/risk-factors-for-developing-scoliosis-in-cerebral-palsy-a-cross-sectional-descriptive-study
#6
Carlo M Bertoncelli, Federico Solla, Peter R Loughenbury, Athanasios I Tsirikos, Domenico Bertoncelli, Virginie Rampal
This study aims to identify the risk factors leading to the development of severe scoliosis among children with cerebral palsy. A cross-sectional descriptive study of 70 children (aged 12-18 years) with severe spastic and/or dystonic cerebral palsy treated in a single specialist unit is described. Statistical analysis included Fisher exact test and logistic regression analysis to identify risk factors. Severe scoliosis is more likely to occur in patients with intractable epilepsy ( P = .008), poor gross motor functional assessment scores ( P = ...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28384608/segmental-kinematic-analysis-of-planovalgus-feet-during-walking-in-children-with-cerebral-palsy
#7
Karen M Kruger, Katherine A Konop, Joseph J Krzak, Adam Graf, Haluk Altiok, Peter A Smith, Gerald F Harris
Pes planovalgus (flatfoot) is a common deformity among children with cerebral palsy. The Milwaukee Foot Model (MFM), a multi-segmental kinematic foot model, which uses radiography to align the underlying bony anatomy with reflective surface markers, was used to evaluate 20 pediatric participants (30feet) with planovalgus secondary to cerebral palsy prior to surgery. Three-dimensional kinematics of the tibia, hindfoot, forefoot, and hallux segments are reported and compared to an age-matched control set of typically-developing children...
March 23, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28384379/repeated-lumbar-or-ventricular-punctures-in-newborns-with-intraventricular-haemorrhage
#8
REVIEW
Andrew Whitelaw, Richard Lee-Kelland
BACKGROUND: Although in recent years the percentage of preterm infants who suffer intraventricular haemorrhage (IVH) has reduced, posthaemorrhagic hydrocephalus (PHH) remains a serious problem with a high rate of cerebral palsy and no evidence-based treatment. Survivors often have to undergo ventriculoperitoneal shunt (VPS) surgery, which makes the child permanently dependent on a valve and catheter system. This carries a significant risk of infection and the need for surgical revision of the shunt...
April 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28379915/total-knee-arthroplasty-in-patients-with-cerebral-palsy-a-matched-cohort-study-to-patients-with-osteoarthritis
#9
Matthew T Houdek, Chad D Watts, Cody C Wyles, Robert T Trousdale, Todd J Milbrandt, Michael J Taunton
INTRODUCTION: Currently, few data examine the use of total knee arthroplasty (TKA) in patients with cerebral palsy (CP). This study reviewed the outcomes of TKA in patients with CP compared with a matched cohort undergoing TKA for primary osteoarthritis. METHODS: Over a 28-year period, 15 TKAs in patients with a diagnosis of CP were identified. The cohort was 53% men, with a mean age of 58 years. Patients with CP were matched 1:2 based on age, sex, body mass index, and year of surgery with a group of patients undergoing TKA for osteoarthritis...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28379484/evaluating-the-discriminant-validity-of-the-pediatric-evaluation-of-disability-inventory-computer-adaptive-test-in-children-with-cerebral-palsy
#10
Benjamin J Shore, Benjamin G Allar, Patricia E Miller, Travis H Matheney, Brian D Snyder, Maria A Fragala-Pinkham
Background: The PEDI-CAT is a new clinical assessment for children and youth from birth through 20 years of age. Objective: To determine the discriminant validity of the PEDI-CAT according to Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) in children with cerebral palsy (CP). Design: A prospective convenience cross-sectional sample of 101 school-aged children with CP was stratified by GMFCS level...
March 31, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28375967/rectus-femoris-transfer-surgery-worsens-crouch-gait-in-children-with-cerebral-palsy-at-gmfcs-levels-iii-and-iv
#11
Ted C Sousa, Alexander Nazareth, Susan A Rethlefsen, Nicole M Mueske, Tishya A L Wren, Robert M Kay
BACKGROUND: Previous study has shown that children with cerebral palsy (CP) functioning at Gross Motor Function Classification System (GMFCS) levels III and IV do not benefit from distal rectus femoris transfer (DRFT) due to lack of improvement in stance knee extension. The fate of knees in such subjects who do not undergo DRFT is unknown. The purpose of this study was to compare knee kinematic outcomes in patients with CP and stiff knee gait who underwent single-event multilevel surgery with and without DRFT...
April 3, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28373616/oculomotor-nerve-palsy-in-a-patient-with-a-ruptured-middle-cerebral-artery-aneurysm
#12
Suguru Yokosako, Yuichiro Kikkawa, Ririko Takeda, Toshiki Ikeda, Hiroki Kurita
We describe a case of acute oculomotor nerve palsy caused by a ruptured middle cerebral artery (MCA) aneurysm. A 59-year-old female presenting with headache and nausea was admitted to our hospital. Her consciousness was alert, and had no other neurological deficit without left oculomotor nerve palsy. A computed tomography (CT) showed SAH extending from left sylvian cistern to basal cistern. CT angiography revealed a left MCA aneurysm which protruded toward internal carotid artery. The patient was successfully treated with surgical clipping...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28371738/abnormality-of-standing-posture-improves-in-patients-with-bilateral-spastic-cerebral-palsy-following-lower-limb-surgery
#13
P Buddhdev, N R Fry, R LePage, M Wiley, M Gough, A P Shortland
OBJECTIVES: The degree of abnormality of the gait pattern of children with bilateral spastic cerebral palsy (BSCP) can be reduced by lower limb orthopaedic surgery. However, little attention is paid to the effects of surgery on standing posture. Here, we investigated the abnormality of standing posture in young people with BSCP as well as the effects of surgery on standing posture. METHODS: We have developed an index of standing posture, the Standing Posture Score (SPS), which is similar in composition to the gait profile score (GPS)...
March 9, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28358778/presurgical-concerns-of-primary-family-caregivers-of-children-with-cerebral-palsy
#14
Li-Chun Yu, Li-Chin Chen, Hsiu-Chen Lin, Yueh-E Lin, Chia-Hsieh Chang, Shu-Ching Chen
BACKGROUND: Primary family caregivers (PFCs) of children with cerebral palsy have many worries and concerns when their children face orthopedic surgery. Levels of PFC stress about the upcoming surgery is related to the child's level of gross motor function as well as the support they receive from medical professionals. PURPOSE: The purposes of the present study were to (1) explore the levels of concern about orthopedic surgery; and (2) explore the predictive factors associated with concerns about orthopedic surgery among PFCs of children with cerebral palsy during the preoperative period...
March 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28317070/lumbar-translaminar-fenestration-for-insertion-of-intrathecal-baclofen-catheter-a-novel-technique
#15
Manraj K S Heran, Hisham Al-Shikarchy, Carolyn Chowne
Intrathecal baclofen has long been known to be an efficacious treatment of spasticity in children with cerebral palsy. Test bolus administration is often necessary to ensure patients will benefit from this treatment. The introduction of a intrathecal catheter for test bolus administration can prove challenging in a subset of this population, particularly those who have received surgery with postoperative spinal fusion masses. We outline a novel technique of inserting a spinal catheter for test bolus administration in a patient with a postoperative fusion mass whereby a fenestration is created through the lamina using an osteotomy needle...
March 20, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28291217/-early-postoperative-results-of-surgical-treatment-of-patients-with-anterior-clinoidal-meningiomas
#16
S V Chernov, D A Rzaev, A V Kalinovsky, A B Dmitriev, A R Kasymov, A V Zotov, E V Gormolysova, E K Uzhakova
Resection of anterior clinoidal meningiomas is a challenging task due to their localization, frequent involvement of the major cerebral arteries and cranial nerves, a high risk of postoperative neurological deficits, and low radicalness of surgery. AIM: To evaluate the radicalness of microsurgical removal and a neurological deficit in the early postoperative period in patients with anterior clinoidal meningiomas. MATERIAL AND METHODS: A total of 35 patients with anterior clinoidal meningiomas underwent surgery at the Department of Neurooncology of the Novosibirsk Federal Neurosurgical Center in the period from 2013 to July 2016...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28279852/effectiveness-of-surgical-and-non-surgical-management-of-crouch-gait-in-cerebral-palsy-a-systematic-review
#17
REVIEW
Scott A Galey, Zachary F Lerner, Thomas C Bulea, Seymour Zimbler, Diane L Damiano
BACKGROUND: Cerebral palsy (CP) is a prevalent group of neuromotor disorders caused by early injury to brain regions or pathways that control movement. Patients with CP exhibit a range of functional motor disabilities and pathologic gait patterns. Crouch gait, characterized by increased knee flexion throughout stance, is a common gait pattern in CP that increases energy costs of walking and contributes to ambulatory decline. Our aim was to perform the first systematic literature review on the effectiveness of interventions utilized to ameliorate crouch gait in CP...
February 24, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28278135/the-influence-of-the-unaffected-hip-on-gait-kinematics-in-patients-with-hemiplegic-cerebral-palsy
#18
Mikhail Tretiakov, Khanh P Do, Michael Aiona
BACKGROUND: Hemiplegic cerebral palsy (HCP) patients have transverse-plane gait deviations that may include the "uninvolved" side. The aim of this study is to quantify the static rotational profile, the dynamic position during gait and determine whether any correlations between the involved and uninvolved side exist. METHODS: A total of 171 subjects that met the inclusion criteria of HCP and no prior history of bony surgery were reviewed. Clinical and gait measurements were analyzed and compared between subjects and a population of typically developing (TD) children...
April 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28262923/outcomes-after-scoliosis-surgery-for-children-with-cerebral-palsy-a-systematic-review
#19
REVIEW
Rachel Toovey, Adrienne Harvey, Michael Johnson, Louise Baker, Katrina Williams
AIM: This study aims (1) to evaluate and synthesize the evidence for the postoperative outcomes after scoliosis surgery for children with cerebral palsy (CP), and (2) to identify preoperative risk factors for adverse outcomes after surgery. METHOD: Medline, EMBASE, CINAHL, and PubMed were searched for relevant literature. Included studies were assessed for risk of bias using the Cochrane Effective Practice and Organisation of Care tool. Quality of evidence for overall function, quality of life (QoL), gross motor function, caregiver outcomes, deformity correction, and postoperative complications were assessed using GRADE (Grades of Recommendation, Assessment, Development and Evaluation)...
March 6, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28242571/predictors-for-anterior-pelvic-tilt-following-surgical-correction-of-flexed-knee-gait-including-patellar-tendon-shortening-in-children-with-cerebral-palsy
#20
Harald Böhm, Matthias Hösl, Leonhard Döderlein
INTRODUCTION: Patellar tendon shortening procedure within single event multilevel surgeries was shown to improve crouch gait in Cerebral Palsy (CP) patients. However, one of the drawbacks associated to the correction of flexed knee gait may be increased pelvic anterior tilt with compensatory lumbar lordosis. RESEARCH QUESTION: Which CP patients are at risk for excessive anterior pelvic tilt following correction of flexed knee gait including patellar tendon shortening? METHODS: 32 patients with CP between 8 and 18 years GMFCS I&II were included...
February 21, 2017: Gait & Posture
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