Analysis of the literature data on the surgical treatment of feet deformities in children with cerebral palsy allowed determining of the first key pathogenesis aspects and management of surgical treatment. The main types of changes occurring in the feet under the influence of spastic disorders and the optimal methods of progressive deformities of feet surgical treatment were studied. The treatment management preference depends on intrapatient habits, age, the pattern of rescue, deformation gravity and mobility, level of the gross motor function (GMFCS). Various «soft tissue surgery» forms are effective provided sufficient deformation mobility for younger children group patients. The bone-cutting feet surgical measures are justified provided rigid deformations in more older children. A differentiated neurogenic feet deformities surgical treatment approach provides obtaining both early and long-term satisfactory treatment results.
In the article the authors consider such methods of the alternative/complementary treatment of the cerebral palsy (CP), presented in the modern domestic and foreign literature, as metabolic (amino acid composites), metamer (I.A. Skvortsov), intravenous administration of baclofen, antiepileptic (vagal stimulation, levetiracetam), acupuncture, transcranial cerebral micropolarization, epidural stimulation, modified motion-induced restriction therapy (MMIRT), stem cell therapy, as well as some other complementary/palliative approaches to the correction of clinical manifestations of various forms of CP. The final part of the article presents the attitude of modern evidence-based medicine to the main methods of the alternative/complementary treatment of cerebral palsy. These data are based almost exclusively on international systematic reviews and relevant meta-analyses.
There are presented own data of comprehensive clinical and instrumental examination of cerebral palsy (CP) patients. The study included 313 patients (183 boys and 130 girls) aged from 1 year to 18 years, with the established diagnosis of CP (ICD 10 code - G80). In addition, spastic CP (G80.0) was diagnosed in 103 patients, spastic diplegia (G80.1) in 98 patients, pediatric hemiplegia (G80.2) in 46 children, another type of CP (G80.8) - in 66 patients. The data of a comparative analysis of clinical symptoms and results of instrumental examinations of patients with various forms of CP are presented.
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