The results of surgical treatment for pronation deformities of the forearm in cerebral palsy after a mean follow-up of 17.5 years
| Autor: | Aleksandar Lesic, Stanislav Rajković, Goran Cobeljic, Zoran Bajin, Marko Aleksić, Henry Dushan Atkinson, Marko Bumbasirevic |
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| Jazyk: | angličtina |
| Předmět: |
Adult
Male Myotomy medicine.medical_specialty Adolescent medicine.medical_treatment Cerebral palsy Young Adult Forearm Humans Medicine Pronation Orthopedics and Sports Medicine Musculoskeletal Diseases Child Muscle Skeletal business.industry Cerebral Palsy Pronator quadratus muscle Pronator teres muscle medicine.disease Extensor carpi radialis brevis muscle Surgery medicine.anatomical_structure Child Preschool Upper limb Female business Range of motion Follow-Up Studies Research Article |
| Zdroj: | Journal of Orthopaedic Surgery and Research |
| ISSN: | 1749-799X |
| DOI: | 10.1186/s13018-015-0251-3 |
| Popis: | Aim This study evaluates the effects of three surgical procedures in the treatment of pronation deformities of the forearm in cerebral palsy patients; namely the transposition of pronator teres to extensor carpi radialis brevis muscle; and rerouting of the pronator teres muscle with or without pronator quadratus muscle myotomy. Methods Sixty-one patients, 48 male/13 female, with a mean age of 17 years (5–41 years) were treated between 1971 and 2011. Pronator teres transposition was performed in 10, pronator rerouting in 35, and pronator rereouting with pronator quadratus myotomy in 16 patients. Ranges of motion, and assessments using the Quick Dash, Mayo Scoring, and Functional Classification system of upper extremity, were made before and after surgery. Mean follow-up was 17.5 years (3–41 years). Results All three procedures led to significantly improved ranges of motion and upper limb function, with good/excellent results in 80 % of patients. Mean active supination improved from 10 ° (0–60 °) to 85 ° (30–90 °) (p 0.05). Conclusion Surgery is very effective in the management of pronation deformities of the forearm in patients with cerebral palsy. Isolated pronator teres rerouting is probably the most effective and simple technique. Adjunctive pronator quadratus myotomy does not lead to an improvement in the results and requires an additional surgical approach. There should be no age restriction to surgery, as all age groups appear to benefit from similar improvements in range of motion and upper limb function. |
| Databáze: | OpenAIRE |
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