Authors : Badarinath Athani, Anil Kumar Gaur, Anand Varma
DOI : 10.18231/j.pjms.2023.071
Volume : 13
Issue : 2
Year : 2023
Page No : 372-377
Background: Over the years, most often the surgical management of cerebral palsy (CP) has focused only on lower extremities wherein surgeries are performed regularly for sitting, standing and ambulation. Upper extremity surgery is uncommonly done to improve the functions of the hand.
Objective: To study effectiveness of tendon transfers in upper extremity in the management of spastic hemiplegia
Materials and Methods: This was a prospective study, which included 24 patients with spastic hemiplegia, of either sex between the ages of 5 and 25 years. All the patients were admitted and evaluated in detail. Pre-operative functional assessment of the upper limb was done according to the House et al functional classification and recorded. IQ evaluation of all the patients was done. All the patients were subjected to the three surgical procedures.
Results: Majority (33.33%) belonged to 16–20 years and 66.67% were Females. 15 (62.5%) were having Rt. Sided involvement 20 (83.33%) were having a Normal IQ (>70). The pre-operative score significantly improved from 1.42 to 4.54 after surgery. No one was having excellent improvement but 25% had good improvement while 58.3% had fair improvement. 16.7% had poor improvement. Out of the four cases having Mild MR, majority, 3 (75%), showed Poor observed improvement scores. Out of the 20 cases having Normal IQ, majority, 13 (65%), showed Fair observed improvement scores.
Conclusion: The appearance of the hand improved in all the 24 cases (100%) making improvement in the appearance of the hand a very important functional and psychological goal for surgical management even in severe cases
Keywords: Effectiveness, Upper extremity, Management, Spastic hemiplegia