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The Archives of Bone and Joint Surgery، جلد ۷، شماره ۴، صفحات ۰-۰
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عنوان انگلیسی Percutaneous Versus Open Hamstring Lengthening in Spastic Diplegic Cerebral Palsy
چکیده انگلیسی مقاله Background: Open hamstring lengthening (oHSL) is com‌monly performed in children with spastic Diplegia to decrease knee contracture and to improve gait and posture. Percutaneous hamstring lengthening (pHSL) is also gaining popularity. This study aimed to compare the results of pHSL versus oHSL and to determine the efficacy and safety of the percutaneous approach. Methods: In this retrospective study, 54 patients (108knees), with spastic diplegia were operated for flexed knee gait with either open or percutaneous HSL. The mean age at the time of surgery was 10.3  1.7 (range 5 to 25) years in open group and 8.5  1.5 (range 7 to 23) years for percutaneous group. Overall, 29 and 25 children underwent oHSL and pHSL, respectively. Results: The mean follow up was 19.1 (range: 12-49) months for oHSL and 18.3 (range: 14-45) months for pHSL groups. In the open group, the mean preoperative popliteal angle decreased from 64.33.6 to 28.44.3 (P< 0.001), and in percutaneous group, from 63.82.7 to 29.52.3 (P< 0.001), with similar improvement (P=0.83). The GMFCS (Gross Motor Function Class Score) within each group improved (p< 0.001), but improvement was not significantly different between the groups (P = 0.88). Average hospital stay in percutaneous group was 1.6 (range:1-3) days, while in open group was 3.6 (range:2-6) days, a significant difference (P = 0.001). Average total cost in the percutaneous group was $333 in comparison to $473 in the open group (P = 0.001). There was no significant difference between the groups regarding complication rate(P=0.85). Conclusion: Percutaneous HSL is a safe, easy, rapid and brief procedure that is as effective as the open technique for children with spastic diplegia in short term but a longer follow up is needed to confirm the findings. Level of Evidence: Level III-retrospective comparative study
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نویسندگان مقاله | Javad Khaje Mozafari
bone and joint reconstruction reseach center, shafa orthopaedic hospital, Iran university of medical sciences, Tehran, iran


| Karim Pisoudeh
bone and joint reconstruction center,shafa orthopedic hospital,iran university of medical sciences, tehran, IR Iran


| kaveh Gharani zadeh
Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran, IR Iran


| Mansour Abolghasemian
Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran, IR Iran
نشانی اینترنتی http://abjs.mums.ac.ir/article_12512.html
فایل مقاله اشکال در دسترسی به فایل - ./files/site1/rds_journals/328/article-328-1668102.pdf
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زبان مقاله منتشر شده en
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نوع مقاله منتشر شده RESEARCH PAPER
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