NEUROORTHOPEDICAL APPROACH TO THE CORRECTION OF EQUINES CONTRACTURE IN PATIENTS WITH SPASTIC PARALYSIS

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Abstract


The frequency of recurrent contractures of the joints of the lower limb after their correction by means of tendon-muscle plasty remains significant. Therefore, the search for effective ways to correct contractures with the most resistant long-term result is relevant. The objective of the study is to improve treatment outcomes of equinus contracture in children with spastic paralysis. Materials and methods. We analyzed the results of correction of contractures in joints of lower limbs in 40 patients with cerebral palsy and the influence of spasticity of patognomonic muscles on them. The mean age was 6 years 7 months. In addition, for the correction of hypertonus of triceps muscle of tibia, the 330 lower limb segments were performed selective neurotomy of appropriate motor branches of the general tibial nerve. This operation in 304 cases was combined with achilloplastics or Strayer operation. Results. A mean degree of correlation between the degree of contracture in the ankle and increased tone of triceps tibia was determined (r value ranged from 0.451 to 0.487). Short-term results of the combined neuroorthopedic method for correction of contractures were good in estimating within 1 year post surgery, but a study of its short-run effect requires long-term follow-up.

Valery Vladimirovich Umnov

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

Email: umnovvv@gmail.com
MD, DMedSc, Head of the department of infantile cerebral palsy

Alexei Vasilievich Zvozil

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

MD, PhD, senior research associate of the department of infantile cerebral palsy

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