Soft tissue release of the spastic hip by psoas-rectus transfer and adductor tenotomy for long-term functional improvement and prevention of hip dislocation.

Abstract

The purpose of this study was to assess the long-term development of children with cerebral palsy treated with soft tissue releases of the hip and, if necessary, also of the hamstrings and the Achilles tendon. The follow-up had to consider the functional status and the hip centration. Seventy-one patients (46 with tetrapareses, 24 with dipareses, and one with triparesis) who underwent soft tissue releases of the hip by the so-called psoas-rectus transfer at an average age of 7 years were assessed preoperatively, after 1 year and at an average age of 19 years. Functional status and the radiological lapse were assigned. The functional status of the patients significantly improved (P<0.001) after surgery. The number of patients who were able to walk increased from 49.3 to 80.3%. The migration percentage decreased from 26.6 to 17.3%. For medium-to-severe functional deficits, a clear gain of function and a safe prevention of spastic hip luxation were achieved.