Efficacy of neuro-othopaedic surgery for distal lower limb spastic deformities: A retrospective study about 161 patients
| Autor: | A.L. Seichepine, M.Y. Grauwin, André Thevenon, Nadine Nachef, Etienne Allart, Christian Fontaine, N. Buisset, Marc Rousseaux |
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| Rok vydání: | 2015 |
| Předmět: |
Neurotomy
medicine.medical_specialty Orthotics Cerebral palsy Physical medicine and rehabilitation Neuro-orthopaedic surgery medicine Spastic Orthopedics and Sports Medicine Spasticity Gait Stroke biology business.industry Rehabilitation Retrospective cohort study biology.organism_classification medicine.disease Tendon lengthening Surgery Valgus Physical therapy medicine.symptom business |
| Zdroj: | Annals of Physical and Rehabilitation Medicine. 58 |
| ISSN: | 1877-0657 |
| DOI: | 10.1016/j.rehab.2015.07.194 |
| Popis: | Objective Distal lower limb deformities are frequent after a central nervous system lesion, and have a significant impact on posture, gait and activity. This study aimed at analyse neuro-orthopaedics procedures performed in such indications, considering their timing, their main functional objectives and their global efficacy on gait and walking conditions. Methods One hundred sixty-one adult patients were assessed at the spasticity multidisciplinary consultation of Lille University hospital and then operated on in 2012 and 2013. Data were analysed retrospectively and included disease history, main functional objectives, nature of surgical procedures and their timing of realization and finally a qualitative analysis of analytic and functional results at the end of the treatment (with a one year post-surgery period). Results Patients presented with consequences of stroke (57.8%), traumatic brain injury (11.8%), cerebral palsy (9.3%); median post-lesion period was 3.5 years. The objective for patients was an improvement of gait (94.4%) and transfer (7,5%), and a reduction in walking aids (6.8%). Ninety-six patients (59.6%) were operated on twice; in this case, the first surgical phase consisted most of time in neurotomies, the second one in tendinous and articular procedures. At the end of the treatment, goals were totally reached in 2/3 of patients and at least in part in 30% of them. Kinematic abnormalities during gait (equinus, varus, valgus, toe claws) were clearly improved. Finally, the need of assistance when walking or making transfers and the need for orthotics were significantly reduced. Discussion This study confirms the efficacy of neuro-orthopaedic treatment of distal lower limb spastic deformities on gait and walking conditions. Efficacy on activities, participation and quality of life remains to be studied. |
| Databáze: | OpenAIRE |
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