1.Management of spastic lower extremities in cerebral palsy.
Philippine Journal of Surgical Specialties 1993;48(2):67-69
Surgery in spastic lower extremities among cerebral palsy is reserved for patients with a reasonable chance to ambulate, to correct the spastic deformity and to improve gait. This study aims to assess the local results of various soft tissue operations such as adductor tenotomy, hamstring release, tendon of Achilles lengthening and tendon transfers. From December 1989 to January 1992, twenty one cerebral palsy children were included in this study. Preoperatively, two of these 21 patients were freely ambulatory. After surgery, 14 were free ambulators and 7 were crutch walkers. These results showed that soft tissue surgery is effective. Combined with intensive physical therapy, optimum ambulatory function of spastic cerebral palsy patients can be achieved. (Author)
Human ; Male ; Female ; Child ; Child Preschool ; Muscle Spasticity ; Cerebral Palsy ; Tenotomy ; Tendon Transfer ; Walkers ; Crutches ; Gait ; Achilles Tendon ; Lower Extremity
2.Early results of supracondylar femoral osteotomy in severe knee flexion contractures in polio patients.
Molano Alberto Ma. V ; Lim Tiong SAM
Philippine Journal of Surgical Specialties 1992;47(1):41-44
Twenty one polio patients with severe knee flexion contractures admitted at the Santo Tomas University Hospital, Clinical Division from 1984 to 1990 were studied. There were 11 males and 10 females with age ranging from 12 to 18 years with a mean of 14.3 years. The degree of knee flexion ranged from 45 to 120 degrees with an average of 62.5 degrees. Clinical data included the ranges of motion, the stability of the hip, knee and ankle. Manual muscle testing as well as limb length and girth were recorded. the technique as described by Huckstep was conducted either as a one or two staged procedure with or without preliminary skeletal tractions. One patient required an internal fixation on the osteotomized fragments for stability. Two patients had residual flexion contracture of 5 ad 10 degrees after removal of cast. Only one patient abandoned her braces and opted to use her wheel chair despite healed osteotomy. (Author)
Human ; Male ; Female ; Adolescent ; Child ; Osteotomy ; Patients ; Poliomyelitis
3.The functional outcome of arthroscopic anterior cruciate ligament reconstruction in patients using different graft tension during tibial fixation
Gabriel Alfonso B JAVIER ; Alberto Ma. V MOLANO
Journal of Medicine University of Santo Tomas 2019;3(1):270-276
Background:
Anterior Cruciate Ligament (ACL) reconstruction is commonly performed to restore knee
kinematics and halt the progression of osteoarthritis.
A primary variable that could infl uence the outcome
of ACL reconstruction is the tension applied to the
graft at the time of fi xation. If the tension is too great,
an abnormal compressive force could potentially develop across the tibiofemoral joint, hindering knee
motion, and subjecting the articular surfaces to increased stress. If the tension in the graft is too low,
the graft will not be effective in restoring normal kinematics. The Tegner Lysholm Knee Scale is a functional scoring for patients with ligamentous injuries. It is
a patient-reported measure of knee function and is
important for comprehensive assessment conditions
in both the clinical and research context. Our objective was to compare which tension technique (15 lbs graft tension using a Mitek Tensioner™ vs maximal
sustained two-hand technique) would yield better
functional outcome at 6 months and 12 months postoperatively using the Tegner Lysholm Knee Scale.
Methods :
Twenty-nine patients who underwent arthroscopic ACL reconstruction at the University of
Santo Tomas Hospital Private Division were randomly divided equally into two groups (group A or group
B). During tibial fi xation, group A would receive 15
lbs graft tension using a Mitek Tensioner and group
B would receive graft tension using the maximal sustained two-handed pull technique. The patients underwent a standard rehabilitation protocol at an institution of their choice and a Lysholm Scoring Scale
and Tegner activity scale were self-administered at 6
months and 12 months after the surgery in order to
assess their functional outcome.
Results :
The results showed that the functional outcome scores of group A were higher than group B.
The yielded p-value was 0.10 (6 months), 0.07 (12
months) for group A and 0.27 (6 months), 0.46 (12
months) for group B. The results showed no suffi cient
evidence of a signifi cant difference between the effects of arthroscopic ACL reconstruction with 15 lbs
weight using a Mitek Tensioner (group A) and graft
tension using the maximal sustained two-handed pull technique (group B) in the knee functional outcome of
patients at 6 months and 12 months postoperatively
Conclusion
The functional outcome scores of patients who underwent ACL reconstruction using different graft tension did not show signifi cant results.
Further re-evaluation of patients’ functional outcome
score is necessary after 12 months postoperatively.
The desired tensioning technique of the ACL surgeon
would be at his/her convenience knowing beforehand the pros and cons of each technique.
Lysholm Knee Score
;
Tibia