Cerebral Palsy Research Today is a free monthly online journal that collates and summarizes the latest research about Cerebral Palsy, including details on symptoms, causes, types.

Multilevel orthopaedic surgery in group IV spastic hemiplegia.

Graham HK, Baker R, Dobson F, Morris ME

Hugh Williamson Gait Laboratory, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.

Most children with spastic hemiplegia have high levels of function and independence but fixed deformities and gait abnormalities are common. The classification proposed by Winters et al is widely used to interpret hemiplegic gait patterns and plan intervention. However, this classification is based on sagittal kinematics and fails to consider important abnormalities in the transverse plane. Using three-dimensional gait analysis, we studied the incidence of transverse-plane deformity and gait abnormality in 17 children with group IV hemiplegia according to Winters et al before and after multilevel orthopaedic surgery.We found that internal rotation of the hip and pelvic retraction were consistent abnormalities of gait in group-IV hemiplegia. A programme of multilevel surgery resulted in predictable improvement in gait and posture, including pelvic retraction. In group IV hemiplegia pelvic retraction appeared in part to be a compensating mechanism to control foot progression in the presence of medial femoral torsion. Correction of this torsion can improve gait symmetry and function.

Published 29 March 2005 in J Bone Joint Surg Br, 87(4): 548-55.
Full-text of this article is available online (may require subscription).

© 2004-2009 Cerebral Palsy Research Today. All Rights Reserved.