CLINICAL-RESULTS OF EARLY ORTHOPEDIC MANA GEMENT IN DUCHENNE MUSCULAR-DYSTROPHY

Although the cause of Duchenne muscular dystrophy has been recently 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 and a lengthening of the tendo calcaneus in 32 patients. The me an age of DMD patients at time of operation was 6.1 yrs. The mean foll ow-up was 3.4 yrs. All children underwent mobilization the day after s urgery. Complete correction of all contractures was immediately achiev ed after operation and kept in all but two cases up to the follow-up e xamination. No loss of ambulation was observed. Our results demonstrat e that early selective surgery in DMD patients before or just at the o nset of contractures without performing an additional aponeurectomy of the iliotibial band and percutaneous tenotomy of the hamstrings accor ding to the original Glorion-Rideau-technique safely prevents severe c ontractures and should prolongate ambulation.