Selective muscle release for the hip in cerebral palsy.

概要

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Formerly there have been recognized many probrems of the hip in cerebral palsy such as subluxation, dislocation, adduction and flexion deformity, scissors gait and pain by osteoarthritis. They were as the results of spasticity and umbalanced muscle tension around the hip joint in cerebral palsy.Many operative approuches were performed and so their problems were solved. The most popular procedure was adductor tenotomy and obturator neurectomy. But, this operative procedure had new troubles such as weekness of adductor muscles and abduction deformity of the hip reversely. And so, we planned the new prosedure that have no muscle weekness and only redused the spasticity of muscles. Scinse 1983, we operated 21 cases (29 hips) of cerebral palsy in Fukuoka Shinkoen handicapped children's hospital. Our prosedure is the elongation of tendons of psoas, rectus femoris, adductor longus and hamstring muscles and tenotomy of gracilis muscle at the hip joint. There tendons are thought to be spastic muscles of the hip in cerebral palsy and we do not release short adductor muscles and iliacus muscle that are paralitic and not spastic in cerebral palsy. So by our prosedure, reduction of dislocated hips and good muscle balance are achieved and this improved their ADL.
西日本整形・災害外科学会の論文