PROLONGATION OF AMBULATION IN CHILDREN WITH DUCHENNE MUSCULAR-DYSTROPHY BY SUBCUTANEOUS LOWER-LIMB TENOTOMY

To assess the effect of subcutaneous (s.c.) lower limb tenotomies on t he ambulatory ability of patients with Duchenne muscular dystrophy (DM D), 54 patients were followed. Twenty-nine patients underwent hip, kne e, and ankle tenotomies at a mean age of 10 2/12 years and were follow ed postoperatively for an average of 3 9/12 years. These children cont inued ambulation in long-leg braces to a mean age of 12 8/12 years and stood to an average of 13 5/12 years. Contracture correction was 49% at the hip, 58% at the knee, and 100% at the ankle. A separate group o f 25 children to whom operation was offered but declined, was followed : these children ceased ambulating at a mean age of 10 years and cease d standing at a mean age of 10 2/12 years. Thus, we propose that s.c. tenotomy is effective in allowing braced ambulation well beyond what t he natural history would allow.