CASE REPORTS
JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

Herbert capsuloplasty and Burnei tenomyoplasty for the correction of genu flexum in cerebral palsy, arthrogryposis and posttraumatic.

Chirurgia 2013 November
INTRODUCTION: Studies of gait dynamics revealed the complex motions that the knee must undergo in sync with the hip and ankle, in both the swing and support phase of walking. If these motions are restricted, usually as a consequence of cerebral palsy or arthrogryposis, normal gait is hindered; the patient may be able to walk for very short distances or, eventually, not at all. Children with knee extension limited by 10 - 30 degrees,especially those with cerebral palsy, exhibit a stance compatible with walking. Walking is difficult and the gait pattern, "crouch gait", is considered typical for this degree of limitation.

AIM: This paper is meant as an update regarding the usefulness of Herbert knee capsuloplasty, conceived in 1938 and introduced in Romania in 1956 by Clement Baciu, and Burneidistal medial hamstring tenomyoplasty, invented in 1993.

MATERIALS AND METHODS: Herbert knee capsuloplasty, although initially intended for ailments other than spasticity or arthrogryposis,became known, in time, as a useful operation for spastic genu flexum with a 15 to 30 degree limitation of extension. Severing the posterior cruciate ligament (PCL) in children less than 10 years old often results in genu recurva tumor joint instability. In order to avoid these complications, PCL transection has been phased out and our clinic started to use, preferentially for spastic genu flexum rather than arthrogryposis,the Burnei tenomyoplasty. When applied in the same operative session, the two techniques complement each other and act in synergy.

RESULTS: Herbert capsuloplasty can achieve only partial correction of genu flexum ranging between 30 and 60 degrees of extension deficit. Full extension is opposed by the PCL,contracture of the hamstrings and vascular retraction. Burnei tenomyoplasty used by itself is useful for genu flexum with less than 30 degrees of extension deficit. For children with 30 to 60 degrees of knee extension deficit, combining the Herbertand Burnei procedures achieves the best results.

CONCLUSIONS: The simultaneous application of Herbert capsuloplasty and Burnei tenomyoplasty allows for the correction of stiff genu flexum and enables the patient to resume walking,with or without support. This course of treatment also avoids the progression of genu flexum beyond 60 degrees, which would require an osteotomy. This combined procedure avoids the cartilage lesions which may develop when patients with 30- 60 degree genu flexum undergo Herbert capsuloplasty alone.Not in the least, the risk of postoperative knee dislocation is significantly reduced.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app