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Adductors tenotomy in spastic cerebral palsy

OBJETIVE: Radiographic evaluation of the evolution of hips that underwent soft-tissue release. METHODS: Retrospective study of 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. Twenty-nine were non-ambulatory, 5 were ambulatory domestically and 10 ambulatory. Reimers' index (RI) and the acetabular index (AI) were measured, pre- and post-operatively, with a minimum follow-up of 3 years. The mean age at the time of surgery was 6.4 years. RESULTS: Results were considered good if the RI was reduced or had increased less than 10%. Results were good for 52% of this study. We observed a clear improvement of IR, in addition to presenting the worst results, in patients older than five years in follow-up. CONCLUSION: Soft-tissues releases should be done as soon as the patient clinically presents less than 30º of hip abduction, regardless the age, level of functioning, clinical type, RI, AI and sex, to help patients in the prevention and treatment of the subluxation, hygiene, and pain relief.

Cerebral palsy; Hip dislocation


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