Long-Term Results of Single-Event Multilevel Surgery in Children with Spastic Hemiplegia
نویسنده
چکیده
hip surveillance in children with cerebral palsy attending our institution from March 2014 to April 2015. Result Of 527 patients coded as cerebral palsy 457 suffered from CP by definition. 30 children suffered from unilateral CP, 153 from bilateral spastic CP, one from ataxic CP, 18 dyskinetic CP and in 30 patients a dominant symptom was not coded. Only 247 patient older than 2 years of age received at least one pelvis X-ray between their first and last consultation with the neuropaediatrician. The functional levels were as follows: GMFCS I n = 36, II n = 50, III n = 63, IV n = 33 and V n = 65 [mean age 9.6 years (2–18 years); 147 male, 100 female]. Of the 247 patients with X-ray, 51 X-rays showed a Reimers migration percentage (MP) of[50 %, 51 a MP 31 to 49 % and the rest\30 %. Conclusion We analyzed these rather disillusioning results, the exterior differences to functioning hip surveillance systems as well as the interior problems. There are several ways to improve the results. The ideal way is the implementation of a nationwide screening programme, but this will need to be organized and will cost money. Another possibility is to organize a ‘‘sensible’’ screening for the children at risk (with GMFCS III–V) according to F. Miller. Our solution was to communicate the results within our institution and to start a special clinic only for hip surveillance in CP according to the already communicated X-ray standards and clinical examinations. As long as there is no nationwide screening programme any paediatric orthopaedic surgeon concerned with the care of CP children should act according to the known rules of hip surveillance. Neuroorthopedics: Lecture VKO-126
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تاریخ انتشار 2017