Document Type : Original Article
Authors
1
Orthopedic surgery resident, The National Institute of Neuromotor System, Egypt
2
Orthopaedic, faculty of medicine, Zagazig university, Zagazig, Egypt.
3
Orthopedic, TheNational Institute Of Neuro-motor System , Egypt
Abstract
Abstract
Background
Cerebral palsy (CP) is the most common motor disability in childhood, affecting approximately one in 323 children. It disrupts muscle control, balance, and posture, often resulting in abnormal walking patterns. As a result, children with CP frequently require a blend of surgical and nonsurgical treatments throughout their lives.
Single-event multilevel surgery (SEMLS) is considered the leading surgical method for improving gait and overall function in ambulatory children with CP. This approach involves addressing all musculoskeletal deformities that contribute to gait abnormalities in one surgical procedure, allowing for faster mobilization and shorter recovery times for the patient.
Methods
Our methodology encompasses various surgical procedures, such as psoas muscle lengthening at the pelvic brim, hip adductors lengthening at the groin crease, medial hamstring fractional lengthening, gastrocnemius muscle recession, and Z-plasty Achilles tendon lengthening. These surgeries are conducted under deep general anesthesia and muscle relaxants, tailored to each patient's specific requirements without the need for symmetry.
Results
Our findings reveal significant improvements in gait, range of motion, and quality of life post-soft tissue surgery, attributed to the dual correction of muscle length and joint loading forces.
Conclusion
The study concludes that single-event soft tissue surgery proves valuable and effective in rectifying all patient deformities, circumventing the challenges associated with multiple operations. Additionally, performing examinations under general anesthesia, customizing procedures based on individual deformities, and prioritizing Achilles tendon lengthening as the final step are crucial practices for achieving successful surgical outcomes.
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