The main approaches to the knee joint stabilization in patients with cerebral palsy

• Main Author: V. V. Umnov
• Format: Article
• Language: Russian
• Published: Vreden Russian Research Institute of Traumatology and Orthopedics 2013-09-01
• Series: Travmatologiâ i Ortopediâ Rossii
• Subjects: детский церебральный паралич; сгибательная контрактура коленного сустава; сгибатели голени; капсулотомия коленного сустава; cerebral palsy in children; flexion contracture of knee joint; knee joint flexors; capsulotomy of knee joint
• Online Access: https://journal.rniito.org/jour/article/view/363
• ISSN: 2311-2905; 2542-0933

Objective: to improve the results of surgical correction of flexion contracture of knee joint in patients with cerebral palsy. Material and methods. 196 patients with cerebral palsy aged from 2.5 to 18 years old were examined. In 131 patients aged from 8 to 18 years old we performed lengthening of tibia flexors with posterior capsulotomy and without it, in 4 patients aged from 11 to 16 years old the contracture was corrected after preliminary reduction of muscle tone using lumbar dorsal selective rhizotomy (LDSR). Among 246 operated segments a slight contracture in 23 cases was eliminated only with lengthening of tibia flexors, in the remaining 223 cases in addition after lengthening of tibia flexors the residual contracture was corrected by the method of pre-dosed correction in plaster cast. In 16 segments if there was a severe contracture we performed a posterior capsulotomy of knee joint. Besides, we investigated the dependence of contraction degree from phase-tonic activity of tibia flexors, as well as the influence of LDSR on the possibility to correct flexion contracture in 65 knee joints of patients aged from 2.5 to 16 years old. Results. The high degree of dependence of knee flexion contracture (KFC) from tone increase of tibia muscle flexors (correlation coefficient r p