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Cerebral palsy surgery

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https://www.readbyqxmd.com/read/28651738/gross-motor-function-change-after-multilevel-soft-tissue-release-in-children-with-cerebral-palsy
#1
Chia-Hsieh Chang, Yu-Ying Chen, Kuo-Kuang Yeh, Chia-Ling Chen
BACKGROUND: Improving motor function is a major goal of therapy for children with cerebral palsy (CP). However, changes in motor function after orthopedic surgery for gait disorders are seldom discussed. This study aimed to evaluate the postoperative changes in gross motor function and to investigate the prognostic factors for such changes. METHODS: We prospectively studied 25 children with CP (4-12 years) who were gross motor function classification system (GMFCS) level II to IV and and underwent bilateral multilevel soft-tissue release for knee flexion gait...
June 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28650877/the-resurgence-of-botulinum-toxin-injection-for-strabismus-in-children
#2
Marielle Mahan, J Mark Engel
PURPOSE OF REVIEW: The present review discusses recent advances in the use of botulinum toxin for the management of strabismus in children. RECENT FINDINGS: Botulinum toxin injection produces similar results compared to surgery for certain subtypes of strabismus, especially acute onset esotropia. It may be more effective in many subtypes of esotropia where surgery has been less reliable, including partially accommodative esotropia, esotropia associated with cerebral palsy, and thyroid eye disease...
June 24, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28649479/functional-outcomes-of-childhood-selective-dorsal-rhizotomy-20-to-28-years-later
#3
T S Park, Jenny L Liu, Caleb Edwards, Deanna M Walter, Matthew B Dobbs
BACKGROUND: Selective dorsal rhizotomy (SDR) is a surgical method used to treat childhood spastic cerebral palsy (CP). However, the effects of early SDR on functional outcomes and quality of life decades later in adulthood remains to be elucidated. OBJECTIVES: To evaluate the long-term outcomes in terms of satisfaction and mobility of adult patients who received childhood SDR. METHODS: Adult patients who received SDR in childhood were surveyed...
May 17, 2017: Curēus
https://www.readbyqxmd.com/read/28629941/does-patella-lowering-improve-crouch-gait-in-cerebral-palsy-comparative-retrospective-study
#4
Eric Desailly, Camille Thévenin-Lemoine, Nejib Khouri
BACKGROUND: Patellalowering aims to improve quadriceps function as a means of correcting crouch gait in patients with cerebral palsy (PC). Few studies have assessed the effects of patella lowering as a component of multilevel surgery. HYPOTHESIS: Including patella lowering into the components of multilevel surgery is beneficial in patients with crouch gait and patella alta. MATERIAL ET METHODS: In 12 lower limbs with patella alta (Caton-Deschamps index >1...
June 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28628523/effectiveness-of-surgery-for-adults-with-hallux-valgus-deformity-a-systematic-review
#5
Jitka Klugarova, Victoria Hood, Fiona Bath-Hextall, Miloslav Klugar, Jana Mareckova, Zuzana Kelnarova
BACKGROUND: Hallux valgus (HV) is a common foot deformity. In severe stages of this condition, surgery is often necessary. Currently, there is no systematic review comparing the effectiveness of surgery over conservative treatment. OBJECTIVES: The objective of this review was to establish the effectiveness of surgery compared to conservatory management for adults with HV. INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review included adults (18 years or over) with HV deformity, excluding adults with neurological problems causing foot deformities, for example, cerebral palsy, neuropathy, stroke and multiple sclerosis...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28617943/long-term-impact-of-childhood-selective-dorsal-rhizotomy-on-pain-fatigue-and-function-a-case-control-study
#6
Alecia K Daunter, Anna L Kratz, Edward A Hurvitz
AIM: Selective dorsal rhizotomy (SDR) is a surgical treatment for spasticity in children with cerebral palsy (CP). Studies suggest long-lasting effects of SDR on spasticity; long-term effects on symptoms and function are not clear. This study tested whether adults with CP (average 22y after SDR) report less pain, fatigue, and functional decline than a retrospectively assessed non-surgical comparison group. METHOD: This was a case-control study. Eighty-eight adults with CP (mean age 27y; SDR=38 male/female/missing=20/16/2; non-surgical [comparison]=50, male/female=19/31) recruited from a tertiary care center and the community completed a battery of self-reported outcome measures...
June 15, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28587475/management-of-severe-equinovalgus-in-patients-with-cerebral-palsy-by-naviculectomy-in-combination-with-midfoot-arthrodesis
#7
Chakravarthy U Dussa, Leonhard Döderlein, Raimund Forst, H Böhm, Albert Fujak
BACKGROUND: Equinovalgus deformity is the second most common deformity in cerebral palsy and may be flexible or rigid. Several operative methods from joint sparing to arthrodesis have been described with varying success rates. The aim of this study was to investigate the effectiveness of naviculectomy in combination with midfoot arthrodesis (talo-cuneiform and calcaneocuboid arthrodesis) in the correction of a rigid equinovalgus foot deformity in cerebral palsy. METHODS: Forty-eight rigid equinovalgus feet were operated upon in 30 patients from 2008 to 2013...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28574882/surgical-outcomes-of-posterior-spinal-fusion-alone-using-cervical-pedicle-screw-constructs-for-cervical-disorders-associated-with-athetoid-cerebral-palsy
#8
Kei Watanabe, Toru Hirano, Keiichi Katsumi, Masayuki Ohashi, Hirokazu Shoji, Akiyoshi Yamazaki, Tomohiro Izumi, Kazuhiro Hasegawa, Takui Ito, Naoto Endo
STUDY DESIGN: Retrospective case series. OBJECTIVE: To investigate clinical outcomes after posterior spinal fusion (PSF) using cervical pedicle screw (CPS) constructs for cervical disorders associated with athetoid cerebral palsy (CP). SUMMARY OF BACKGROUND DATA: Traditionally, most patients with cervical myelopathy associated with CP have required combined anterior and posterior fusion to achieve solid stability against severe involuntary movement...
June 1, 2017: Spine
https://www.readbyqxmd.com/read/28566775/orthopedic-surgery-in-cerebral-palsy-instructional-course-lecture
#9
Deepak Sharan
Orthopedic surgery (OS) plays an important role in the management of cerebral palsy (CP). The objectives of OS are to optimize functions and prevent deformity. Newer developments in OS for CP include emphasis on hip surveillance, minimally invasive procedures, use of external fixators instead of plates and screws, better understanding of lever arm dysfunctions (that can only be corrected by bony OS), orthopedic selective spasticity-control surgery, and single-event multilevel lever arm restoration and anti spasticity surgery, which have led to significant improvements in gross motor function and ambulation, especially in spastic quadriplegia, athetosis, and dystonia...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28562561/comparison-of-mid-term-efficacy-of-spastic-flatfoot-in-ambulant-children-with-cerebral-palsy-by-2-different-methods
#10
Jie Wen, Hong Liu, Sheng Xiao, Xin Li, Ke Fang, Ming Zeng, Zhongwen Tang, Shu Cao, Fanling Li
To compare the treatment efficacy of spastic flatfoot surgery by 2 different surgical methods: nonfusion subtalar arthroereisis using subtalar joint stabilizer (SJS) and Dennyson-Fulford subtalar arthrodesis (D-FSA).A total of 26 cases of ambulant children with cerebral palsy diagnosed as spastic flatfoot were surgically treated from January 2011 to December 2014. Preoperative and postoperative American Orthopedic Foot and Ankle Society-Ankle and Hindfoot (AOFAS-AH) scores, anteroposterior-talocalcaneal angles (ATAs), and lateral talar-first metatarsal angles (Meary angles) of the affected foot were recorded...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28553449/post-operative-hypertension-following-correction-of-flexion-deformity-of-the-knees-in-a-spastic-diplegic-child-a-case-report
#11
Mohan Vipin, D M Sujendra, V K Imthiaz, Hitesh-Shah
An adolescent boy with spastic diplegic cerebral palsy presented with crouch gait. He had bilateral severe flexion deformities of knees and hips. He was treated with single event multilevel surgery for the correction of deformities. Surgical procedures included bilateral adductor release, iliopsoas lengthening, bilateral femoral shortening and patella plication. Persistent hypertension was noted in the post-operative period. All causes of secondary hypertension were ruled out. Having persistent hypertension following the femoral shortening procedure is unusual...
November 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28537994/changes-in-gait-parameters-after-femoral-derotational-osteotomy-in-cerebral-palsy-patients-with-medial-femoral-torsion
#12
Ha Yong Kim, Yong Han Cha, Jae Yong Byun, Young Sub Chun, Won Sik Choy
Medial femoral torsion (MFT) is a common pathologic gait in cerebral palsy (CP) children that can be corrected by femoral derotational osteotomy (FDO). It is not clearly known as to how much various gait parameters change after FDO. The aim of this study was to quantify changes in gait parameters after FDO. The study group included 19 young CP patients (28 limbs, age<20 years, average age: 13.2 years) with symptomatic MFT, treated with distal FDO. The study group was divided into two groups: the unilateral FDO group (UG) and the bilateral FDO group (BG)...
May 19, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28520679/knee-recurvatum-in-children-with-spastic-diplegic-cerebral-palsy
#13
Jeremy Bauer, K Patrick Do, Jing Feng, Rosemary Pierce, Michael Aiona
BACKGROUND: The purpose of this study is to determine which factors drive patients with diplegic cerebral palsy to walk without knee recurvatum despite hyperextension of the knee on physical examination. METHODS: A retrospective review was conducted of all data collected in the Gait Analysis Laboratory between 1999 and 2014. Patients with spastic diplegic cerebral palsy and at least 5 degrees of knee extension on clinical examination were identified for the study...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28465219/differences-in-body-composition-according-to-gross-motor-function-in-children-with-cerebral-palsy
#14
Ki Hyuk Sung, Chin Youb Chung, Kyoung Min Lee, Byung Chae Cho, Seung Jun Moon, Jaeyoung Kim, Moon Seok Park
OBJECTIVES: To assess differences in body composition according to gross motor function in children with cerebral palsy (CP) compared to healthy controls. DESIGN: Retrospective case control study. SETTING: Tertiary referral center for CP PARTICIPANTS: One hundred consecutive patients (mean age, 11.5 ± 4.2 years) with CP who were admitted for orthopedic surgery between May 2014 and March 2016 and 46 typically developing children (TDC, control group) were included...
April 29, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28449964/recurrence-of-deep-surgical-site-infection-in-cerebral-palsy-after-spinal-fusion-is-rare
#15
Amit Jain, Urvij M Modhia, Dolores B Njoku, Suken A Shah, Peter O Newton, Michelle C Marks, Tracey P Bastrom, Firoz Miyanji, Paul D Sponseller
STUDY DESIGN: Retrospective review of prospective registry. OBJECTIVES: To assess the following in children with cerebral palsy (CP) who develop deep surgical site infection (DSSI) after spinal fusion: (1) rate of infection recurrence after treatment; (2) treatments used; (3) radiographic outcomes; and (4) differences in Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) scores versus those of children with no infection (NI). SUMMARY OF BACKGROUND DATA: Studies show high rates of surgical site infection in patients with CP but do not address late recurrence or quality-of-life effects...
May 2017: Spine Deformity
https://www.readbyqxmd.com/read/28443277/pediatric-hand-surgery-training-in-nicaragua-a-sustainable-model-of-surgical-education-in-a-resource-poor-environment
#16
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
#17
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
#18
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
#19
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...
June 2017: Early Human Development
https://www.readbyqxmd.com/read/28401027/beneficial-effects-of-childhood-selective-dorsal-rhizotomy-in-adulthood
#20
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
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