Distal tibial and fibular derotation osteotomy in patients with cerebral palsy

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1N F4TIEMS M’RIP CERlBRAL PALSY Stdko, M5.. S.J. DeeSwti, MD, DR. Wenger, MD., D.H. Sutherland, M.D., K.R. Kaufmman, PhD.. h4.P. Wyatt, MA.. R.P.T., H.6. Chambers, MD, iMotion Analysis Laboratory Zu:drsn’s Hospitd ad Health Center San Diego, Ca. 92123

WBS $0 -t 4 years ( 4 + 6 yrs WI9 + 2 yrs). All

Mean age at time of osi~otomy

patients were ambulatory

with or wirhour awnrive

devices. Mea foilowup period All patients tmdenvent manual goniome:ric tsstmg of static join: xxstions by one of Wo orthopedic surgeons utilizing the same go~iom?cer both preo~rafively and postopemtiveiy. Computerized 3D gait ma:ysz ofdymmic pid rotations and time d:stmn-e parameters was obtained ~eoperativel~ and postoperaweiy uti!izing Vicon software and standard marker sets. Wneiratic pazneten studied inciuded tibial rotation and foot progression argle at 30% (,tidswxe) and 50% (teninal stance) of the no.mnlized gait cycle. Preoperative and posto~w&e values for these parameters were tben compared to determine if alignment wx improved by the operative procedure. Kistler force @ate data were obtained on patients who were indcpndant ambulators. Subjective changes m gait patfen. as noted by the patients and or parents, were &so recorded at PstoPxxtive gait analysis. m ‘Ebial iofafm: Al! patients showed imixw%d tibial rotation at postoperative gst an&sis. Mean improvema~ at 30% gait cycle was 25.7 degrees (0.0-70.0) m m kq?roverr?ent ar 50% gas cycle was 3i.i degrees (10.0 70.0). Foot progresrion ang!e: All @ems showed improvement in foot progressicn was 24.9 montks (15 mon!bs to 5: monrhsj.

xigls at post operarive

git

analysis.

.Mervl Imprcwment

degrees (0.0 - 30.0). Mean Improvement 40.0).

at 30% g2it cycle was 14.3

et 50% gair cycle was 18.9 degrees (5.0 -