Treatment of the Scissor Posture in the Cerebral Palsies

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Transplantation of the inner hamstring muscles (sometimes semitendinosus only) at their distal attachment and myotomy of the adductor were undertaken in cerebral palsy with higher grade scissor posture.Pre-and postoperative training was done by use of training apparatus combined bracing for the night.The hypertonicity of the muscles in the lower extremities was analysed by means of stretch reflexes and indication of the operative procedure was researched.Higher grade scissor posture was treated by operation and training, whereas mild cases was by training only.The flexion and extension of dynamic excercise by use of the apparatus took out training spirit of children.Clinical and electromyographic analysis of the muscle hypertonicity in cerebral palsy sorted out rigo-spastic patients into the RIGO-spastic type and rigo-SPASTIC type.Also in each patient, individual muscle was different in the distribution of rigid and spastic element.Most of patients with higher grade scissor posture belonged to RIGO-spastic type and rigid element was abundant in the adductor and hamstring than in the gastrocnemius.In these patients modified Eggers' operation was more effective than Baker's operation.