Nik Abdul Adel, Nik Alyani and Abdul Razak, Ardilla Hanim and Awang, Mohd Shukrimi and Loh, LL (2020) Single event multilevel surgery in spastic patient : a Hospital Tengku Ampuan Afzan (HTAA) experience. In: Sarawak Paediatric Orthoapedic Symposium, 10th-12th January 2020, Kuching, Sarawak. (Unpublished)
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Abstract
INTRODUCTION: Single event multilevel surgery (SEMLS) is common procedure to improve gait and functioning of children with spastic cerebral palsy(CP).These series is aim to observe post-operative outcomes of gross motor function (GMFCS) and hip migration index (MI). MATERIALS & METHODS: Patient underwent SEMLS at HTAA from 2014 to 2018.Data were data taken from case notes during follow-up at rehabilitation clinic. RESULTS: There were 10 patients, 6 were boys.Mean age at surgery was 6.6 years old.7 having spastic diplegic and 1 each having triplegic and quadriplegic CP. Table 1: Type of surgery Patient Adductor release Hamstring release Gastrocnemius recession Tendon achilles lengthening Posteromedial release 1 bilateral bilateral 2 bilateral bilateral bilateral 3 bilateral bilateral 4 bilateral bilateral 5 bilateral bilateral Left 6 bilateral bilateral 7 bilateral 8 bilateral bilateral 9 bilateral bilateral 10 bilateral bilateral 2 patients had second surgery at 1 year apart:1 underwent talipes equinovarus deformity correction and another had repeated SEMLS.Only 5patients had pre and post-operative pelvis radiograph where 4 patients(80%) improved in hip MI. Table 2: Improvement of GMFCS level Patient GMFCS Level improvement Pre Post 1 IV III 1 level 2 II II 0 3 III III 0 4 IV III 1 level 5 V V 0 6 IV III 1 level 7 IV IV 0 8 III II 1 level 9 III III 0 10 V V 0 40% of patients have 1 level improvement. 75% of patients with GMFCS IV had improvement compared to GMFCS III (33%). DISCUSSIONS: 73.5% has good improvement of hip MI postoperatively with 0.3% risk of hip surgery1.Incidence of hip displacement related to GMFCS level2.Evidence proved SEMLS improved gait3 and stability of GMFCS4. CONCLUSION: SEMLS may affect the improvement and stability of GMFCS level and hip MI; and that effect is level-dependent. REFERENCES: 1Terjesen et al,Acta Orthopeadica,2009. 2Kentish M.et al,Journal of Peadiatric Rehabilitation Medicine,2011. 3Thomason et al,JBJS,2011. 4Godwin et al,Journal of Peadiatric Orthopaedic,2009.
Item Type: | Conference or Workshop Item (Poster) |
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Additional Information: | 8324/78831 |
Uncontrolled Keywords: | multilevel surgery, spastic patient |
Subjects: | R Medicine > RD Surgery > RD701 Orthopedics |
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): | Kulliyyah of Medicine > Department of Department of Orthopaedics, Traumatology & Rehabilitation Kulliyyah of Medicine |
Depositing User: | Dr Nik Alyani Nik Abdul Adel |
Date Deposited: | 16 Jul 2020 10:12 |
Last Modified: | 16 Jul 2020 10:12 |
URI: | http://irep.iium.edu.my/id/eprint/78831 |
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