Yonsei Med J.  2014 Jan;55(1):191-196. 10.3349/ymj.2014.55.1.191.

The Effect of Obturator Nerve Block on Hip Lateralization in Low Functioning Children with Spastic Cerebral Palsy

• Park ES
• Rha DW
• Lee WC
• Sim EG

• KMID: 1779905
• DOI: http://doi.org/10.3349/ymj.2014.55.1.191

Abstract

PURPOSE
Hip adductor spasticity has a great impact on developing hip displacement in children with cerebral palsy (CP). Obturator nerve (ON) block is less invasive intervention rather than soft tissue surgery for reduction of hip adductor spasticity. The aim of this study is to investigate the effect of ON block on hip lateralization in low functioning children with spastic CP.
MATERIALS AND METHODS
The study was performed by retrospective investigation of the clinical and radiographic follow-up data of low functioning children [gross motor function classification system (GMFCS) level III to V] with spastic cerebral palsy whose hip was subluxated. Migration percentage (MP) was measured on hip radiographs and its annual change was calculated. In intervention group, ON block was done with 50% ethyl alcohol under the guidance of electrical stimulation.
RESULTS
The data of 49 legs of 25 children for intervention group and the data of 41 legs of 23 children for nonintervention group were collected. In intervention group, the MP were significantly reduced at 1st follow-up and the MPs at 2nd and last follow-up did not show significant differences from initial MP. Whereas in nonintervention group, the MPs at 1st, 2nd and last follow-up were all significantly increased compared to initial MPs.
CONCLUSION
ON block with ethyl alcohol is useful as an early effective procedure against progressive hip displacement in these children with spastic CP.

Keyword

Cerebral palsy; hip dislocation; nerve block; obturator nerve

MeSH Terms

Cerebral Palsy/*drug therapy
Child
Child, Preschool
Ethanol/therapeutic use
Female
Humans
Male
Muscle Spasticity/drug therapy
Nerve Block/*methods
Obturator Nerve/*drug effects
Retrospective Studies
Ethanol

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