The Journal of Bone and Joint Surgery, Vol 74, Issue 9 1385-1391, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
Distal lengthening of the hamstrings in patients who have cerebral palsy. Long-term retrospective analysis
SH Dhawlikar, L Root and RL Mann
Hospital for Special Surgery, New York, N.Y. 10021.
One hundred and twenty-six patients who had cerebral palsy and who had been
managed with distal lengthening of the hamstrings were followed for three
to fourteen years so that the long-term results of the procedure could be
determined. Twenty-four of sixty-two patients who could not walk before the
procedure were able to walk about the house postoperatively. Mild
recurvatum developed in only ten patients, and twenty-two patients had a
reoperation because of recurrence. Although straight-leg raising and the
popliteal angle had improved markedly at one year in all but two patients,
both parameters regressed gradually over time. Of several selected
variables, only limitation of straight-leg raising preoperatively was of
statistical significance (p < 0.001) for the prediction of recurrence.
Age, preoperative walking ability, concomitant operations, and
postoperative immobilization had no significant effect on the rates of
recurrence or recurvatum.