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Denervation of the infraspinatus and release of the posterior deltoid muscles in the management of dyskinetic external shoulder rotation in cerebral palsy
Umeå University. Department of Hand and Plastic Surgery, University Hospital of Northern Sweden, Umeå, Sweden.
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Department of Hand and Plastic Surgery, University Hospital of Northern Sweden, Umeå, Sweden.
2015 (English)In: Journal of Neurosurgery: Pediatrics, ISSN 1933-0707, E-ISSN 1933-0715, Vol. 15, no 4, 438-444 p.Article in journal (Refereed) Published
Abstract [en]

OBJECT: The dyskinetic subtype of cerebral palsy is difficult to manage, and there is no established gold standard for treatment. External rotation of the shoulder(s) is often managed nonsurgically using injections of botulinum toxin A into the external rotator muscles. This article reports a new surgical technique for managing external rotation when botulinum toxin A treatment is not sufficient or possible.

METHODS: Six patients with dyskinetic cerebral palsy underwent denervation of the infraspinatus muscle and release of the posterior part of the deltoid muscle. Postoperative questionnaires were given to the patients/caregivers, and video recordings were made both pre- and postoperatively. Preoperative and postoperative Assisting Hand Assessment was possible in only 1 case.

RESULTS: Five patients were very satisfied with their outcome. Four patients' video recordings showed improvement in their condition. One patient developed postoperative complications.

CONCLUSIONS: The results indicate that denervation of the infraspinatus muscle and posterior deltoid release can be an option for patients with dyskinetic cerebral palsy to manage external rotation of the shoulder when other treatment alternatives are insufficient.

Place, publisher, year, edition, pages
2015. Vol. 15, no 4, 438-444 p.
National Category
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-120336DOI: 10.3171/2014.9.PEDS14223ISI: 000351658900017PubMedID: 25580511OAI: oai:DiVA.org:umu-120336DiVA: diva2:928521
Available from: 2016-05-16 Created: 2016-05-16 Last updated: 2016-06-03Bibliographically approved

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Blaszczyk, IzabelaWiberg, Mikael
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Umeå UniversityDepartment of Integrative Medical Biology (IMB)
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Journal of Neurosurgery: Pediatrics
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