痉挛型脑瘫内收肌肌腱切断术的结果

RESULTS OF ADDUCTORS MUSCLE TENOTOMY IN SPASTIC CEREBRAL PALSY.

作者信息

Guglielmetti Luiz Gabriel Betoni, Santos Ruy Mesquita Maranhao, Mendonça Rodrigo Góes Medea de, Yamada Helder Henzo, Assumpçao Rodrigo Montezuma César de, Fucs Patricia Maria de Moraes Barros

机构信息

Resident Physicians in the Department of Orthopedics and Traumatology, Santa Casa School of Medical Sciences, "Femandinho Simonsen" Wing, Santa Casa de Mise-ricórdia de São Paulo.

Attending Physician in the Department of Orthopedics and Traumatology, Santa Casa School of Medical Sciences, "Fernandinho Simonsen" Wing, Santa Casa de Mise-ricórdia de Säo Paulo.

出版信息

Rev Bras Ortop. 2015 Nov 17;45(4):420-5. doi: 10.1016/S2255-4971(15)30391-8. eCollection 2010 Jul-Aug.

DOI:10.1016/S2255-4971(15)30391-8

PMID:27022574

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4799137/

Abstract

OBJECTIVE

Radiographic evaluation of the evolution of hips that underwent soft-tissue release.

METHODS

This was a retrospective evaluation on 101 spastic cerebral palsy patients who underwent soft-tissue release between 1991 and 2006. Forty-four patients met the inclusion criteria: 23 boys and 21 girls; 34 diparetic and 10 quadriparetic. Functionally, 29 were non-walkers, five were able to walk at home and 10 were able to walk within the community. Reimers' index (RI) and the acetabular index (AI) were measured on pre and postoperative radiographs, with a minimum follow-up of three years. The mean age at the time of surgery was 6.4 years.

RESULTS

The results were considered good if the RI had reduced, or had increased by less than 10%. This was found in 52% of this study. We observed a clear improvement in IR, along with worse results in patients with more than five years of postoperative follow-up.

CONCLUSION

Soft-tissue release should be performed as early as possible, regardless of age, walking condition, clinical type, RI, AI or sex, and as soon as the patient clinically presents less than 30° abduction, because of the benefits relating to walking, prevention and treatment of subluxation, hygiene and pain relief.

摘要

目的

对接受软组织松解术的髋关节演变情况进行影像学评估。

方法

这是一项对1991年至2006年间接受软组织松解术的101例痉挛性脑瘫患者的回顾性评估。44例患者符合纳入标准：23例男性和21例女性；34例双侧瘫和10例四肢瘫。功能方面，29例不能行走，5例能在家中行走，10例能在社区内行走。在术前和术后X线片上测量赖默斯指数（RI）和髋臼指数（AI），最短随访3年。手术时的平均年龄为6.4岁。