Borowski Andrzej, Pogonowicz Ewa, Plebański Rafał, Synder Marek, Grzegorzewski Andrzej
Department of Orthopaedics and Paediatric Orthopaedics, Medical University of Łódź, Poland.
Ortop Traumatol Rehabil. 2011 Mar-Apr;13(2):155-61.
The muscle imbalance associated with the spastic type of infantile cerebral palsy may result in subluxations or dislocations of the hip. The aim of the study was to compare the clinical and radiological results of myotomy of the hip adductor muscles versus adductor transfer to the ischiadic tuber in the prevention of hip subluxation and dislocation in infantile cerebral palsy.
The study involved 36 ambulant children with spastic diparetic CP treated at our Department in the years 1987-2002. Group I consisted of 21 children (41 hip joints) who underwent myotomy of the adductor longus, adductor brevis and gracilis muscles. Mean age at the time of surgery was 10 years (3 to 17 years). Group II consisted of 15 children (28 hip joints) who underwent transfer of the tendons of the adductor muscles to the ischiadic tuber. Mean age at the time of surgery in this group was 8 years (3 to 16 years). The mean duration of hospital stay was 6 days in Group I and 9 days in Group II. Rehabilitation was carried out for an average of 3 months in Group I and 4 months in Group II.
The follow-up examination showed improvement in the hip range of motion in both groups and no radiographic differences.
Adductor myotomy is superior to adductor transfer because of easier surgical technique, shorter duration of hospital stay and no need to immobilize the hip.
