CLINICAL-RESULTS OF EARLY ORTHOPEDIC MANAGEMENT IN DUCHENNE MUSCULAR-DYSTROPHY

Although the primary defect of Duchenne muscular dystrophy has been fo und, there is no causal treatment to alter the natural course of this disease. Based on the recommendations by Glorion and Rideau with early treatment of contractures of the hips and the lower limbs we performe d a modified release of the spina muscles, resection of tensor fasciae latae muscle and a lengthening of the tendo calcaneus in 32 patients. The mean age of DMD patients at time of operation was 6.1 years. The mean follow-up was 3.4 years. All children underwent mobilisation the day after surgery Complete correction of all contractures was immediat ely achieved after operation and kept in all but two cases up to the f ollow-up examination after 3.4 years. No loss of ambulation was observ ed.Our results demonstrate that early selective surgery in DMD patient s just at or better before the onset of contractures without performin g an additional aponeurectomy of the iliotibial band and percutaneous tenotomy of the hamstrings according to the original Glorion-Rideau te chnique safely prevents severe contractures and thereby delays the pro gression of scoliosis.