J Korean Acad Rehabil Med.  2010 Oct;34(5):587-590.

Refractures after Operative Fixation in Severe Spastic Cerebral Palsy: A case report

• Ryu JE
• Yoo SH
• Choi GH
• Lee BN

Abstract

Patients with severe cerebral palsy (CP) are susceptible to bone fractures due to low bone mineral density, deformity from contracture and developmental disability. We experienced a 12-year-old spastic CP female who sustained recurrent fracture of the right femur. The first episode occurred when she had been moved passively by another child in residential care. She underwent operative treatment with plate fixation, but seventeen days after operation, spasticity of legs aggravated and refracture happened at the fixation site. She underwent re-operative fixation, but at three days after the second operation, she sustained another fracture at the top of the plate, for which she underwent the third operation. She was then referred to our department for scissoring patterns of the lower extremities. We performed bilateral obturator nerve block which relieved patient's spasticity. We think that her recurrent fracture may be related with ignored risk factor of refracture such as uncontrolled spasticity.

Keyword

Refracture; Cerebral palsy; Spasticity

MeSH Terms

Bone Density
Cerebral Palsy
Child
Congenital Abnormalities
Contracture
Developmental Disabilities
Female
Femur
Fractures, Bone
Humans
Leg
Lower Extremity
Muscle Spasticity
Obturator Nerve
Risk Factors