Effects of Surgical and Non-Surgical Hamstring Lengthening on Hip and Knee Parameters in Children with Cerebral Palsy

Background: This study aims to investigate changes in femoral head anteversion, popliteal angle, and the effect of internal hamstring lengthening on hip rotation in children with CP undergoing surgical and non-surgical interventions.Methods: This retrospective cross-sectional study included ۳۰ children aged ۵-۱۲ years with CP and knee contracture. Patients were divided into two groups: ۱۵ with severe contracture and popliteal angle >۷۰° underwent surgery, and ۱۵ with moderate contracture and popliteal angle ۳۰-۷۰° received non-surgical treatment (botulinum toxin injection). Results: In the surgical group, internal hip rotation decreased by ۱۵°, popliteal angle by ۴۸°, knee extension by ۱۳°, and femoral head anteversion by ۱۰°, while external hip rotation increased by ۱۸°. In the non-surgical group, internal hip rotation decreased by ۱۰°, popliteal angle by ۱۹°, knee extension by ۸°, and femoral head anteversion by ۱۹°, while external hip rotation increased by ۱۰° (All p-values=۰.۰۰۱)Conclusions: Internal hamstring lengthening, both surgical and non-surgical (botulinum toxin injection), improves movement (hip rotation and gait pattern) in children with CP, both surgical and non-surgical medial hamstring lengthening yield significant within-group improvements in hip rotation dynamics, popliteal angles, and knee extension deficits within their respective severity cohorts. Rather than comparing superiority, clinical decision-making should be guided by baseline contracture severity, with surgery reserved for severe structural contractures and botulinum toxin type A utilized for moderate spasticity for children with CP.

کلیدواژه ها:

femoral head anteversion ، Popliteal Angle ، internal hamstring lengthening ، Cerebral palsy