Tenotomies of the adductor muscles with and without neurectomies of N. obturatorius in patients with spastic cerebral palsy: A comparative study

Abstract

Objective: The hip dislocation especially in spastic form of cerebral palsy frequently occurs. It results in significant morbidity in terms of pain in the dislocated hip and destabilization of the pelvis. The aim of this study was to evaluate the migration percentage in patients where only tenotomies of the adductor muscles were performed compared to patients where tenotomies of the adductor muscles were combined with neurectomy of the obturator nerve. Methods: We retrospectively evaluated 50 patients (80 hips) divided in two groups. In 32 patients (47 hips) tenotomies of the adductor muscles were performed, in 18 patients (33 hips) tenotomies of the adductormuscles were combined with neurectomy of the obturator nerve in order to prevent and to decrease the incidence of hip dislocation. We used the Reimers’ hip migration percentage to evaluate the stability of the articulation. Results: In the group where tenotomies of the adductor muscles were combined with neurectomy of the obturator nerve, we cannot find a statistically significant difference when compared to the group where only tenotomies of the adductor muscles were performed. In the two year follow up period after the operations, a decrease of the migration percentage was noted in both groups of patients with gradual increase in the following period. Conclusion: There was no significant difference in the end result when performing tenotomies of the adductor muscles combined with neurectomy of the obturator nerve compared with tenotomies of the adductor muscles only

Keywords

• cerebral palsy
• hip dislocation
• adductor contractures