Postanesthesia alternation of lower limb contractures in children with spastic cerebral palsy

J Pediatr Orthop B. 2020 Jan;29(1):9-14. doi: 10.1097/BPB.0000000000000565.

Abstract

The aim of this study was to clarify the effects of general anesthesia (GA) on joint range of motion (ROM) in children with spastic cerebral palsy (SCP). Eighty-four SCP cases (mean age 8.4 years) admitted for first corrective surgery were retrospectively reviewed. Lower limb ROM were measured 1 day before operation and immediately after GA. Contracture of hip, knee, and ankle joints decreased significantly after GA, with + 11.1° (39.5%) for the hip abduction angle, -3.7° (18.0%) for the Thomas test, -15.0° (19.1%) for the popliteal angle, + 6.6° (39.8%) and 7.0° (109%) for ankle dorsiflexion with knee flexion and extension, respectively (all P < 0.001). These changes were correlated positively to pre-GA contracture and body weight, negatively to age, but independent of preoperative functional level, geographic classification of SCP, or modified Ashworth scale. On the basis of these findings, routine post-GA reassessments of joint ROM before corrective surgeries were recommended for pediatric SCP cases.

MeSH terms

  • Adolescent
  • Anesthesia, General*
  • Ankle Joint / physiopathology
  • Cerebral Palsy / complications*
  • Cerebral Palsy / physiopathology
  • Child
  • Child, Preschool
  • Contracture / etiology
  • Contracture / physiopathology
  • Contracture / surgery*
  • Electromyography
  • Female
  • Follow-Up Studies
  • Gait / physiology
  • Hip Joint / physiopathology
  • Humans
  • Imaging, Three-Dimensional
  • Knee Joint / physiopathology
  • Lower Extremity*
  • Male
  • Muscle Spasticity / physiopathology
  • Muscle Spasticity / surgery*
  • Orthopedic Procedures / methods*
  • Postoperative Period
  • Range of Motion, Articular / physiology*
  • Retrospective Studies