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. 2024;17(1):19-33.
doi: 10.3233/PRM-240018.

Management and treatment of musculoskeletal problems in adults with cerebral palsy: Experience gained from two lifespan clinics

Mark Katsma  1 , Haiqing Liu  2 , Xiaoyu Pan  3   4 , Kyle J Ryan  5   6 , David P Roye  7 , Henry G Chambers  8
Affiliations

Management and treatment of musculoskeletal problems in adults with cerebral palsy: Experience gained from two lifespan clinics

Mark Katsma et al. J Pediatr Rehabil Med. 2024.
No abstract available

Keywords: Cerebral palsy; adults; musculoskeletal; orthopedic surgery.

PubMed Disclaimer

Conflict of interest statement

Henry Chambers, MD, is a consultant for Abbvie Corporation. The other authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1
MRI of 45-year-old man with progressive loss of function of upper and lower extremities as well as urinary incontinence.
Fig. 2
Fig. 2
Patient with a caregiver at university.
Fig. 3
Fig. 3
A physical exam revealed a fixed adduction shortening of the left thigh segment, bilateral knee flexion contractures, bilateral hip flexion contractures, and patella alta.
Fig. 4
Fig. 4
Preoperative x-rays reveal dislocation of the left hip, bilateral knee flexion contractures, and patella alta.
Fig. 5
Fig. 5
Postoperative alignment with improvement of hip extension, knee extension, and patella alta.
Fig. 6
Fig. 6
Postoperative x-rays after proximal femoral extension, varus, and rotation osteotomy, distal femur extension osteotomy, and patellar advancement.
Fig. 7
Fig. 7
Standing posture reveals flexed hip, flexed knee, and ankle dorsiflexion with anterior pelvic rotation.
Fig. 8
Fig. 8
Bilateral positive Ely Test.
Fig. 9
Fig. 9
Bilateral positive Thomas test.
Fig. 10
Fig. 10
Bilateral knee flexion contractures 25 degrees.
Fig. 11
Fig. 11
Preoperative imaging revealed good coverage of the hips, knee flexion, and patella alta. On the CT anteversion, the left was 37 degrees and the right 28 degrees. The neck shaft angle was 131 degrees bilaterally.
Fig. 12
Fig. 12
Right side reconstruction with proximal femur extension rotation osteotomy, distal femur extension osteotomy, and patellar advancement.
Fig. 13
Fig. 13
The left side was performed three months after the right with varus, extension, rotation osteotomy of the proximal femur, extension osteotomy of the distal femur, and advancement of the patella. The neck shaft angles of 131 were reduced to about 120 degrees. The anteversion was slightly increased to account for the external rotation of the limb.
Fig. 14
Fig. 14
Postoperative position.
See this image and copyright information in PMC

References

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