Open Versus Percutaneous Lengthening Of Tendo Achilles In Spastic Cerebral Palsy: A Prospective Study Of Tendo Achilles Lengthening Trauma In Spastic Cerebral Palsy In Al-Yarmouk Teaching Hospital In Iraq | ||
| IRAQI JOURNALOF COMMUNITY MEDICINE | ||
| Article 1, Volume 29, Issue 1, March 2016, Pages 53-59 | ||
| Authors | ||
| Issam Al-Azzawi; Ammar A Mohammed | ||
| Abstract | ||
| Background: Cerebral palsy is a group of none progressive motor problem and physical disorders. Equinus deformity occurs with high frequency in patients with lower extremity CP in both the Hemiplegic and the Diplegic patients, which limits passive ankle dorsiflexion to less than the neutral position and results in characteristic toe-walking gait. Objective: To compare between the two surgical methods for CP patients with Equinus, regarding technique of the operation, post-operative morbidity & complication rates, functional results and advantages of one over the other. Patients & Methods: A prospective study carried out in Al-Yarmouk Teaching hospital for period from March, 2010-October,to 2011 on CP patients with Equinus deformity undergone surgery to correct their deformity by elongation of Tendo Achilles, we chose two methods of lengthening, Open and Percutaneous. Patients with their feet selected randomly to choose the procedure whether percutaneous or open. Follow-up of cases range from (6-12) months with an average of (6) month combined with post-operative physiotherapy and all the results were recorded in a prepared questionnaire. Results: The most serious complications encountered were wound infection and recurrence of equinus: We faced 2 cases (14%) of deep and superficial wound infection in cases treated by Open method. -We faced 5 cases of recurrence of equinus: 4 feet (28.5%) of those treated by open technique. 1 foot (5%) of those treated by percutaneous technique. Fortunately, we didn’t face any case with calcaneus deformity. In our study, percutaneous results seemed to us as an excellent and superior to the Open method results and at most levels. From the results we got, we found that percutaneous method had easier technique, less complicated, more satisfied from the parents and better functional results than that of open method. We got 80% excellent gait with percutaneous method in comparison with 57% for Open method. Conclusions: In our study, percutaneous technique regarded as the technique of choice for surgical correction of primary fixed equinus deformity of the foot in spastic CP child. | ||
| Keywords | ||
| Equinus; Cerebral palsy; Tendo Achillis; Percutaneous lengthening; Open lengthening | ||
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