Kinematic and kinetic analysis of distal derotational osteotomy of the leg in children with cerebral palsy

Raymond M. Stefko, Robert J. De Swart, David A. Dodgin, Marilynn P. Wyatt, Kenton R Kaufman, David H. Sutherland, Henry G. Chambers

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Patients with cerebral palsy often develop rotational deformities of the lower extremities. These deformities may be caused by abnormal muscle tone, soft-tissue contractures, or bony malalignment. When rotational deformity persists after correction of the soft-tissue components, bony-realignment procedures are warranted to improve gait in ambulatory patients. We performed a retrospective review of 10 ambulatory children with cerebral palsy and tibial torsion who underwent 13 distal tibial and fibular derotation osteotomies. Preoperative and postoperative three-dimensional gait analysis were used to determine the effect of distal tibial and fibular derotation osteotomy on tibial rotation, foot-progression angle, gait velocity, and moments about the ankle. Mean tibial rotation and foot-progression angle were significantly improved by the procedure. Gait velocity improved but not significantly. Moment data demonstrated a trend toward normal. This study demonstrates that the derotational distal tibial and fibular osteotomy stabilized with percutaneous crossed Kirschner wires is a safe, reliable, and effective procedure for correcting rotational deformities of the leg in patients with cerebral palsy.

Original languageEnglish (US)
Pages (from-to)81-87
Number of pages7
JournalJournal of Pediatric Orthopaedics
Volume18
Issue number1
DOIs
StatePublished - 1998
Externally publishedYes

Fingerprint

Cerebral Palsy
Osteotomy
Gait
Biomechanical Phenomena
Leg
Foot
Bone Wires
Contracture
Ankle
Lower Extremity
Muscles

Keywords

  • Ambulatory
  • Cerebral palsy
  • Derotation
  • Gait analysis
  • Osteotomy
  • Tibial torsion

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Kinematic and kinetic analysis of distal derotational osteotomy of the leg in children with cerebral palsy. / Stefko, Raymond M.; De Swart, Robert J.; Dodgin, David A.; Wyatt, Marilynn P.; Kaufman, Kenton R; Sutherland, David H.; Chambers, Henry G.

In: Journal of Pediatric Orthopaedics, Vol. 18, No. 1, 1998, p. 81-87.

Research output: Contribution to journalArticle

Stefko, Raymond M. ; De Swart, Robert J. ; Dodgin, David A. ; Wyatt, Marilynn P. ; Kaufman, Kenton R ; Sutherland, David H. ; Chambers, Henry G. / Kinematic and kinetic analysis of distal derotational osteotomy of the leg in children with cerebral palsy. In: Journal of Pediatric Orthopaedics. 1998 ; Vol. 18, No. 1. pp. 81-87.
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