Acta Ortopédica Mexicana

De Pavía-Mota E, Neri-Gámez S, Reyes-Contreras G, Valencia-Posadas M
Percutaneous tenotomy and aponeurotomy (PTA) for knee flexor contracture in children with spastic cerebral palsy
Acta Ortop Mex 2013; 27 (2)

Language: Español
References: 14
Page: 109-113
PDF: 84.10 Kb.

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ABSTRACT

Knee flexor muscle contracture is frequent in patients with spastic cerebral palsy. The purpose of the study was to determine whether percutaneous tenotomy and aponeurotomy may decrease knee flexor contracture in children with spastic cerebral palsy. Material and methods: A prospective study of consecutive cases was conducted from January to December 2009 in 24 children with a diagnosis of moderate to severe spastic cerebral palsy who had knee flexor contracture with a popliteal angle ≥ 45° and a gross motor function classification scale of 4 or 5; they underwent percutaneous tenotomy and aponeurotomy surgery and were followed-up for 24 months. Variance analysis with a factorial design was used for data analysis. Results: The mean popliteal angle was 83.48° preoperatively and 27.30° by the end of the follow-up, with an improvement of 56.18° (p < 0.01). Statistically significant differences were found in all measurements comparing them with the baseline values. Discussion: Percutaneous aponeurotomy of knee flexor muscles is described. Compared to other procedures it provides the benefits of minimally invasive surgery, mild postoperative pain, short hospital stay –without using immobilization during the entire process- and children returned to their therapy program within fi ve days. Conclusion: Percutaneous tenotomy and aponeurotomy of knee flexors was shown to be a good alternative for the treatment of knee flexor contracture in patients with spastic cerebral palsy.


Key words: knee, cerebral palsy, tenotomy, mobility limitation.


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