Distal femoral extension and shortening osteotomy as a part of multilevel surgery in children with cerebral palsy
Background There are several reports describing an increase in anterior pelvic tilt after hamstring lengthening in children with cerebral palsy (CP). Distal femoral extension and shortening osteotomy (DFESO) is an alternative treatment for correction of flexed knee gait, but investigations analyzing...
Gespeichert in:
| Veröffentlicht in: | World journal of pediatrics : WJP 2017-08, Vol.13 (4), p.353-359 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 359 |
|---|---|
| container_issue | 4 |
| container_start_page | 353 |
| container_title | World journal of pediatrics : WJP |
| container_volume | 13 |
| creator | Klotz, Matthias C. M. Hirsch, Klemens Heitzmann, Daniel Maier, Michael W. Hagmann, Sebastien Dreher, Thomas |
| description | Background
There are several reports describing an increase in anterior pelvic tilt after hamstring lengthening in children with cerebral palsy (CP). Distal femoral extension and shortening osteotomy (DFESO) is an alternative treatment for correction of flexed knee gait, but investigations analyzing outcome and influence on adjacent joint are few in the literature. The purpose of this study was to analyze the influence of DFESO on knee and pelvis in children with CP. Furthermore, it was of interest if an additional patellar tendon advancement (PA) influences outcome.
Methods
In this retrospective study, 31 limbs of 22 children (GMFCS I-III; mean age: 12.1±3.1 years), who received DFESO were included and kinematic parameters (knee, pelvis) measured by 3-D-gait analysis were compared before and at least 1 year after surgery (mean follow-up period: 15.6 months).
Results
After surgery, during stance phase minimum knee flexion improved significantly by 20.5° (
P |
| doi_str_mv | 10.1007/s12519-016-0086-y |
| format | Article |
| fullrecord | <record><control><sourceid>wanfang_jour_cross</sourceid><recordid>TN_cdi_wanfang_journals_ssekzz201704010</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><wanfj_id>ssekzz201704010</wanfj_id><sourcerecordid>ssekzz201704010</sourcerecordid><originalsourceid>FETCH-LOGICAL-c343t-672b2f9f3f0e77ec24b90c0feec6cefb57f058f07461ddda3ca0324502052b433</originalsourceid><addsrcrecordid>eNp1kDtPxDAQhC0E4v0DaJA7qsDaSexciXhLSDRQW46zvgsk9mHngPDr8Sk8KqrZlWdm5Y-QIwanDECeRcZLNsuAiQygEtm4QXZZJWQGopKbaZZQZVUpZjtkL8ZnAMGZgG2ywyuQRVHALnm9bOOgO2qx9yEpfgzoYusd1a6hceFD2ls3pz4O6Affj1RHqulSh4F6S_tVN7QdvmFH4yrMMYy0ddQs2q4J6Oh7OyyowYD1unypuzgekC2bFA-_dZ88XV89Xtxm9w83dxfn95nJi3zIhOQ1tzObW0Ap0fCinoEBi2iEQVuX0kJZ2fQPwZqm0bnRkPOiBA4lr4s83ycnU--7dla7uXr2q-DSRRUjvnx-ckh4CmCQnGxymuBjDGjVMrS9DqNioNag1QRaJdBqDVqNKXM8ZZarusfmN_FDNhn4ZIjpySUwf_f_b_0CWnyLyA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Distal femoral extension and shortening osteotomy as a part of multilevel surgery in children with cerebral palsy</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Klotz, Matthias C. M. ; Hirsch, Klemens ; Heitzmann, Daniel ; Maier, Michael W. ; Hagmann, Sebastien ; Dreher, Thomas</creator><creatorcontrib>Klotz, Matthias C. M. ; Hirsch, Klemens ; Heitzmann, Daniel ; Maier, Michael W. ; Hagmann, Sebastien ; Dreher, Thomas</creatorcontrib><description>Background
There are several reports describing an increase in anterior pelvic tilt after hamstring lengthening in children with cerebral palsy (CP). Distal femoral extension and shortening osteotomy (DFESO) is an alternative treatment for correction of flexed knee gait, but investigations analyzing outcome and influence on adjacent joint are few in the literature. The purpose of this study was to analyze the influence of DFESO on knee and pelvis in children with CP. Furthermore, it was of interest if an additional patellar tendon advancement (PA) influences outcome.
Methods
In this retrospective study, 31 limbs of 22 children (GMFCS I-III; mean age: 12.1±3.1 years), who received DFESO were included and kinematic parameters (knee, pelvis) measured by 3-D-gait analysis were compared before and at least 1 year after surgery (mean follow-up period: 15.6 months).
Results
After surgery, during stance phase minimum knee flexion improved significantly by 20.5° (
P
<0.001) and mean anterior pelvic tilt increased by 4.0 degrees (
P
=0.045). In 16 limbs, the postoperative increase in maximum anterior pelvic tilt was more than 5°. Limbs who received an additional PA showed the biggest increase in anterior pelvic tilt.
Conclusions
DFESO is an effective method for correction of flexed knee gait in children with CP. Furthermore, the results of this study indicate that DFESO may lead to an increase in anterior pelvic tilt, which may lead to a recurrence of flexed knee gait. In this context, PA seemed to aggravate the effect on the pelvis.</description><identifier>ISSN: 1708-8569</identifier><identifier>EISSN: 1867-0687</identifier><identifier>DOI: 10.1007/s12519-016-0086-y</identifier><identifier>PMID: 28074440</identifier><language>eng</language><publisher>Hangzhou: Childrens Hospital, Zhejiang University School of Medicine</publisher><subject>Adolescent ; Biomechanical Phenomena ; Bone Lengthening - methods ; Casts, Surgical ; Cerebral Palsy - diagnosis ; Cerebral Palsy - surgery ; Child ; Cohort Studies ; Critical Care Medicine ; Female ; Femur - surgery ; Follow-Up Studies ; Gait - physiology ; Gait Disorders, Neurologic - physiopathology ; Gait Disorders, Neurologic - surgery ; Germany ; Humans ; Imaging ; Intensive ; Knee Joint - physiopathology ; Male ; Maternal and Child Health ; Medicine ; Medicine & Public Health ; Original Article ; Osteotomy - methods ; Pediatric Surgery ; Pediatrics ; Quality of Life ; Radiology ; Range of Motion, Articular - physiology ; Retrospective Studies ; Severity of Illness Index ; Statistics, Nonparametric ; Surgery ; Treatment Outcome</subject><ispartof>World journal of pediatrics : WJP, 2017-08, Vol.13 (4), p.353-359</ispartof><rights>Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg 2016</rights><rights>Copyright © Wanfang Data Co. Ltd. All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c343t-672b2f9f3f0e77ec24b90c0feec6cefb57f058f07461ddda3ca0324502052b433</citedby><cites>FETCH-LOGICAL-c343t-672b2f9f3f0e77ec24b90c0feec6cefb57f058f07461ddda3ca0324502052b433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://www.wanfangdata.com.cn/images/PeriodicalImages/ssekzz/ssekzz.jpg</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12519-016-0086-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12519-016-0086-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27911,27912,41475,42544,51306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28074440$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Klotz, Matthias C. M.</creatorcontrib><creatorcontrib>Hirsch, Klemens</creatorcontrib><creatorcontrib>Heitzmann, Daniel</creatorcontrib><creatorcontrib>Maier, Michael W.</creatorcontrib><creatorcontrib>Hagmann, Sebastien</creatorcontrib><creatorcontrib>Dreher, Thomas</creatorcontrib><title>Distal femoral extension and shortening osteotomy as a part of multilevel surgery in children with cerebral palsy</title><title>World journal of pediatrics : WJP</title><addtitle>World J Pediatr</addtitle><addtitle>World J Pediatr</addtitle><description>Background
There are several reports describing an increase in anterior pelvic tilt after hamstring lengthening in children with cerebral palsy (CP). Distal femoral extension and shortening osteotomy (DFESO) is an alternative treatment for correction of flexed knee gait, but investigations analyzing outcome and influence on adjacent joint are few in the literature. The purpose of this study was to analyze the influence of DFESO on knee and pelvis in children with CP. Furthermore, it was of interest if an additional patellar tendon advancement (PA) influences outcome.
Methods
In this retrospective study, 31 limbs of 22 children (GMFCS I-III; mean age: 12.1±3.1 years), who received DFESO were included and kinematic parameters (knee, pelvis) measured by 3-D-gait analysis were compared before and at least 1 year after surgery (mean follow-up period: 15.6 months).
Results
After surgery, during stance phase minimum knee flexion improved significantly by 20.5° (
P
<0.001) and mean anterior pelvic tilt increased by 4.0 degrees (
P
=0.045). In 16 limbs, the postoperative increase in maximum anterior pelvic tilt was more than 5°. Limbs who received an additional PA showed the biggest increase in anterior pelvic tilt.
Conclusions
DFESO is an effective method for correction of flexed knee gait in children with CP. Furthermore, the results of this study indicate that DFESO may lead to an increase in anterior pelvic tilt, which may lead to a recurrence of flexed knee gait. In this context, PA seemed to aggravate the effect on the pelvis.</description><subject>Adolescent</subject><subject>Biomechanical Phenomena</subject><subject>Bone Lengthening - methods</subject><subject>Casts, Surgical</subject><subject>Cerebral Palsy - diagnosis</subject><subject>Cerebral Palsy - surgery</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Critical Care Medicine</subject><subject>Female</subject><subject>Femur - surgery</subject><subject>Follow-Up Studies</subject><subject>Gait - physiology</subject><subject>Gait Disorders, Neurologic - physiopathology</subject><subject>Gait Disorders, Neurologic - surgery</subject><subject>Germany</subject><subject>Humans</subject><subject>Imaging</subject><subject>Intensive</subject><subject>Knee Joint - physiopathology</subject><subject>Male</subject><subject>Maternal and Child Health</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Osteotomy - methods</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Quality of Life</subject><subject>Radiology</subject><subject>Range of Motion, Articular - physiology</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Statistics, Nonparametric</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>1708-8569</issn><issn>1867-0687</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kDtPxDAQhC0E4v0DaJA7qsDaSexciXhLSDRQW46zvgsk9mHngPDr8Sk8KqrZlWdm5Y-QIwanDECeRcZLNsuAiQygEtm4QXZZJWQGopKbaZZQZVUpZjtkL8ZnAMGZgG2ywyuQRVHALnm9bOOgO2qx9yEpfgzoYusd1a6hceFD2ls3pz4O6Affj1RHqulSh4F6S_tVN7QdvmFH4yrMMYy0ddQs2q4J6Oh7OyyowYD1unypuzgekC2bFA-_dZ88XV89Xtxm9w83dxfn95nJi3zIhOQ1tzObW0Ap0fCinoEBi2iEQVuX0kJZ2fQPwZqm0bnRkPOiBA4lr4s83ycnU--7dla7uXr2q-DSRRUjvnx-ckh4CmCQnGxymuBjDGjVMrS9DqNioNag1QRaJdBqDVqNKXM8ZZarusfmN_FDNhn4ZIjpySUwf_f_b_0CWnyLyA</recordid><startdate>20170801</startdate><enddate>20170801</enddate><creator>Klotz, Matthias C. M.</creator><creator>Hirsch, Klemens</creator><creator>Heitzmann, Daniel</creator><creator>Maier, Michael W.</creator><creator>Hagmann, Sebastien</creator><creator>Dreher, Thomas</creator><general>Childrens Hospital, Zhejiang University School of Medicine</general><general>Department of Orthopedic and Trauma Surgery,Heidelberg University Clinics,Heidelberg,Germany</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>2B.</scope><scope>4A8</scope><scope>92I</scope><scope>93N</scope><scope>PSX</scope><scope>TCJ</scope></search><sort><creationdate>20170801</creationdate><title>Distal femoral extension and shortening osteotomy as a part of multilevel surgery in children with cerebral palsy</title><author>Klotz, Matthias C. M. ; Hirsch, Klemens ; Heitzmann, Daniel ; Maier, Michael W. ; Hagmann, Sebastien ; Dreher, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c343t-672b2f9f3f0e77ec24b90c0feec6cefb57f058f07461ddda3ca0324502052b433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Biomechanical Phenomena</topic><topic>Bone Lengthening - methods</topic><topic>Casts, Surgical</topic><topic>Cerebral Palsy - diagnosis</topic><topic>Cerebral Palsy - surgery</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Critical Care Medicine</topic><topic>Female</topic><topic>Femur - surgery</topic><topic>Follow-Up Studies</topic><topic>Gait - physiology</topic><topic>Gait Disorders, Neurologic - physiopathology</topic><topic>Gait Disorders, Neurologic - surgery</topic><topic>Germany</topic><topic>Humans</topic><topic>Imaging</topic><topic>Intensive</topic><topic>Knee Joint - physiopathology</topic><topic>Male</topic><topic>Maternal and Child Health</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Osteotomy - methods</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Quality of Life</topic><topic>Radiology</topic><topic>Range of Motion, Articular - physiology</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Statistics, Nonparametric</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Klotz, Matthias C. M.</creatorcontrib><creatorcontrib>Hirsch, Klemens</creatorcontrib><creatorcontrib>Heitzmann, Daniel</creatorcontrib><creatorcontrib>Maier, Michael W.</creatorcontrib><creatorcontrib>Hagmann, Sebastien</creatorcontrib><creatorcontrib>Dreher, Thomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Wanfang Data Journals - Hong Kong</collection><collection>WANFANG Data Centre</collection><collection>Wanfang Data Journals</collection><collection>万方数据期刊 - 香港版</collection><collection>China Online Journals (COJ)</collection><collection>China Online Journals (COJ)</collection><jtitle>World journal of pediatrics : WJP</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Klotz, Matthias C. M.</au><au>Hirsch, Klemens</au><au>Heitzmann, Daniel</au><au>Maier, Michael W.</au><au>Hagmann, Sebastien</au><au>Dreher, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Distal femoral extension and shortening osteotomy as a part of multilevel surgery in children with cerebral palsy</atitle><jtitle>World journal of pediatrics : WJP</jtitle><stitle>World J Pediatr</stitle><addtitle>World J Pediatr</addtitle><date>2017-08-01</date><risdate>2017</risdate><volume>13</volume><issue>4</issue><spage>353</spage><epage>359</epage><pages>353-359</pages><issn>1708-8569</issn><eissn>1867-0687</eissn><abstract>Background
There are several reports describing an increase in anterior pelvic tilt after hamstring lengthening in children with cerebral palsy (CP). Distal femoral extension and shortening osteotomy (DFESO) is an alternative treatment for correction of flexed knee gait, but investigations analyzing outcome and influence on adjacent joint are few in the literature. The purpose of this study was to analyze the influence of DFESO on knee and pelvis in children with CP. Furthermore, it was of interest if an additional patellar tendon advancement (PA) influences outcome.
Methods
In this retrospective study, 31 limbs of 22 children (GMFCS I-III; mean age: 12.1±3.1 years), who received DFESO were included and kinematic parameters (knee, pelvis) measured by 3-D-gait analysis were compared before and at least 1 year after surgery (mean follow-up period: 15.6 months).
Results
After surgery, during stance phase minimum knee flexion improved significantly by 20.5° (
P
<0.001) and mean anterior pelvic tilt increased by 4.0 degrees (
P
=0.045). In 16 limbs, the postoperative increase in maximum anterior pelvic tilt was more than 5°. Limbs who received an additional PA showed the biggest increase in anterior pelvic tilt.
Conclusions
DFESO is an effective method for correction of flexed knee gait in children with CP. Furthermore, the results of this study indicate that DFESO may lead to an increase in anterior pelvic tilt, which may lead to a recurrence of flexed knee gait. In this context, PA seemed to aggravate the effect on the pelvis.</abstract><cop>Hangzhou</cop><pub>Childrens Hospital, Zhejiang University School of Medicine</pub><pmid>28074440</pmid><doi>10.1007/s12519-016-0086-y</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1708-8569 |
| ispartof | World journal of pediatrics : WJP, 2017-08, Vol.13 (4), p.353-359 |
| issn | 1708-8569 1867-0687 |
| language | eng |
| recordid | cdi_wanfang_journals_ssekzz201704010 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adolescent Biomechanical Phenomena Bone Lengthening - methods Casts, Surgical Cerebral Palsy - diagnosis Cerebral Palsy - surgery Child Cohort Studies Critical Care Medicine Female Femur - surgery Follow-Up Studies Gait - physiology Gait Disorders, Neurologic - physiopathology Gait Disorders, Neurologic - surgery Germany Humans Imaging Intensive Knee Joint - physiopathology Male Maternal and Child Health Medicine Medicine & Public Health Original Article Osteotomy - methods Pediatric Surgery Pediatrics Quality of Life Radiology Range of Motion, Articular - physiology Retrospective Studies Severity of Illness Index Statistics, Nonparametric Surgery Treatment Outcome |
| title | Distal femoral extension and shortening osteotomy as a part of multilevel surgery in children with cerebral palsy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T22%3A34%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-wanfang_jour_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Distal%20femoral%20extension%20and%20shortening%20osteotomy%20as%20a%20part%20of%20multilevel%20surgery%20in%20children%20with%20cerebral%20palsy&rft.jtitle=World%20journal%20of%20pediatrics%20:%20WJP&rft.au=Klotz,%20Matthias%20C.%20M.&rft.date=2017-08-01&rft.volume=13&rft.issue=4&rft.spage=353&rft.epage=359&rft.pages=353-359&rft.issn=1708-8569&rft.eissn=1867-0687&rft_id=info:doi/10.1007/s12519-016-0086-y&rft_dat=%3Cwanfang_jour_cross%3Essekzz201704010%3C/wanfang_jour_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/28074440&rft_wanfj_id=ssekzz201704010&rfr_iscdi=true |