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The effects of uninvolved side epiphysiodesis for limb length equalization in children with unilateral cerebral palsy: clinical evaluation with the Edinburgh visual gait score

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Hemiplegic cerebral palsy patient may present a shorten leg on the hemiplegic side that afflicts negatively the kinematic of the uninvolved limb. Thus, the aim of this study was to investigate the modification of gait kinematic after epiphysiodesis for limb equalization and secondary to verify the prediction of correction.

Methods

Skeletally immature hemiplegic patients with a minimum limb leg discrepancy (LLD) of 2.5 cm were treated with epiphysiodesis of the unaffected knee and clinically evaluated with Edinburgh visual gait score (EVGS). Green–Anderson curve was used to predict time decision for correction.

Results

Ten LLD patients were evaluated with the Edinburgh visual gait score (EVGS) before and after surgery. Mean age was 12.7 years, mean follow-up was 6.7 years, and mean LLD was 3.4 cm before surgery and 1.2 cm at final follow-up. After lower limb equalization surgery, improvement in gait kinematics was observed on both the uninvolved and hemiplegic limb of hemiplegic cerebral palsy patients (p < 0.001). Final correction did not reach expected correction (2.3 vs. 2.8 cm). However, the difference was not statistically significant (p = 0.058).

Conclusion

This is the first study to report improvement on both the uninvolved and hemiplegic limb gait kinematics after limb equalization surgery. Due to the impaired dorsiflexion of the hemiplegic foot, LLD target at the end of growth should range between 0.5 and 1.5 cm.

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Authors and Affiliations

  1. Orthopedic and Trauma Clinic, Padua University Hospital, 35127, Padua, Italy

    Marco Corradin

  2. Orthopaedics and Traumatology Unit, Vicenza General Hospital, 36100, Vicenza, Italy

    Roberto Schiavon

  3. Orthopedic and Trauma Unit, Padua General Hospital, 35127, Padua, Italy

    Andrea Borgo

  4. Orthopedic Surgery Department, Clinique St. Odilon, 3 Avenue du Professeur Sorel, 03300, Moulins, France

    Jacques Deslandes

  5. IRCCS Institute of Neurological Sciences, Bellaria Hospital, Via Altura 3, 40100, Bologna, Italy

    Antonella Cersosimo

  6. Pediatric Surgery Department, CHU Estaing–Clermont, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France

    Federico Canavese

Authors
  1. Marco Corradin
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  2. Roberto Schiavon
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  3. Andrea Borgo
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  4. Jacques Deslandes
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  6. Federico Canavese
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Correspondence to Marco Corradin.

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Corradin, M., Schiavon, R., Borgo, A. et al. The effects of uninvolved side epiphysiodesis for limb length equalization in children with unilateral cerebral palsy: clinical evaluation with the Edinburgh visual gait score. Eur J Orthop Surg Traumatol 28, 977–984 (2018). https://doi.org/10.1007/s00590-017-2097-3

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  • DOI: https://doi.org/10.1007/s00590-017-2097-3

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