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Prevention of severe contractures might replace multilevel surgery in cerebral palsy: results of a population-based health care programme and new techniques to reduce spasticity

Hägglund, Gunnar LU ; Andersson, Sofia LU ; Düppe, Henrik LU ; Pedertsen, HL; Nordmark, Eva LU and Westbom, Lena LU (2005) In Journal of Pediatric Orthopedics. Part B 14(4). p.269-273
Abstract
During the 1990s three new techniques to reduce spasticity and dystonia in children with cerebral palsy (CP) were introduced in southern Sweden: selective dorsal rhizotomy, continuous intrathecal baclofen infusion and botulinum toxin treatment. In 1994 a CID register and a health care programme, aimed to prevent hip dislocation and severe contractures, were initiated in the area. The total population of children with CP born 1990-1991, 1992-1993 and 1994-1995 was evaluated and compared at 8 years of age. In non-ambulant children the passive range of motion in hip, knee and ankle improved significantly from the first to the later age groups. Ambulant children had similar range of motion in the three age groups, with almost no severe... (More)
During the 1990s three new techniques to reduce spasticity and dystonia in children with cerebral palsy (CP) were introduced in southern Sweden: selective dorsal rhizotomy, continuous intrathecal baclofen infusion and botulinum toxin treatment. In 1994 a CID register and a health care programme, aimed to prevent hip dislocation and severe contractures, were initiated in the area. The total population of children with CP born 1990-1991, 1992-1993 and 1994-1995 was evaluated and compared at 8 years of age. In non-ambulant children the passive range of motion in hip, knee and ankle improved significantly from the first to the later age groups. Ambulant children had similar range of motion in the three age groups, with almost no severe contractures. The proportion of children treated with orthopaedic surgery for contracture or skeletal torsion deformity decreased from 40 to 15% (P=0.0019). One-fifth of the children with spastic diplegia had been treated with selective dorsal rhizotomy. One-third of the children born 1994-1995 had been treated with botulinum toxin before 8 years of age. With early treatment of spasticity, early non-operative treatment of contracture and prevention of hip dislocation, the need for orthopaedic surgery for contracture or torsion deformity is reduced, and the need for multilevel procedures seems to be eliminated. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
prevention, cerebral palsy, contracture, total population
in
Journal of Pediatric Orthopedics. Part B
volume
14
issue
4
pages
269 - 273
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:15931031
  • wos:000230362100007
ISSN
1473-5865
language
English
LU publication?
yes
id
f646af15-5564-4855-abcb-6145ec140fd4 (old id 233024)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15931031&dopt=Abstract
date added to LUP
2007-08-22 09:47:15
date last changed
2016-04-15 19:53:55
@article{f646af15-5564-4855-abcb-6145ec140fd4,
  abstract     = {During the 1990s three new techniques to reduce spasticity and dystonia in children with cerebral palsy (CP) were introduced in southern Sweden: selective dorsal rhizotomy, continuous intrathecal baclofen infusion and botulinum toxin treatment. In 1994 a CID register and a health care programme, aimed to prevent hip dislocation and severe contractures, were initiated in the area. The total population of children with CP born 1990-1991, 1992-1993 and 1994-1995 was evaluated and compared at 8 years of age. In non-ambulant children the passive range of motion in hip, knee and ankle improved significantly from the first to the later age groups. Ambulant children had similar range of motion in the three age groups, with almost no severe contractures. The proportion of children treated with orthopaedic surgery for contracture or skeletal torsion deformity decreased from 40 to 15% (P=0.0019). One-fifth of the children with spastic diplegia had been treated with selective dorsal rhizotomy. One-third of the children born 1994-1995 had been treated with botulinum toxin before 8 years of age. With early treatment of spasticity, early non-operative treatment of contracture and prevention of hip dislocation, the need for orthopaedic surgery for contracture or torsion deformity is reduced, and the need for multilevel procedures seems to be eliminated.},
  author       = {Hägglund, Gunnar and Andersson, Sofia and Düppe, Henrik and Pedertsen, HL and Nordmark, Eva and Westbom, Lena},
  issn         = {1473-5865},
  keyword      = {prevention,cerebral palsy,contracture,total population},
  language     = {eng},
  number       = {4},
  pages        = {269--273},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Pediatric Orthopedics. Part B},
  title        = {Prevention of severe contractures might replace multilevel surgery in cerebral palsy: results of a population-based health care programme and new techniques to reduce spasticity},
  volume       = {14},
  year         = {2005},
}