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VagusX -> Indications for tendon lengthening (Is it appropriate?) (February 3, 2004 5:12:00 AM)
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Hi everybody,
I have been requested my a doc to supply my opinions on a tendon lengthening procedure on one of my CP teenagers (13 y/o.)
She is a spastic quad with low cognitive levels. She had a tendon lengthening procedure when she was 5 and had a baclofen pump installed 2.5 years ago. Unfortunatly the Baclofen pump did little for her spacticity and actually ended up decreasing her ability to ambulate and move about. Currently she very limited by her spasticity, her lack of focus, and her difficulties with disassociating her movements. When she does want to walk she looks like she is putting every ounce of energy that she has into the task. I continue to work on this goal with her because I would love to see her ambulate for short distances inside of her school.
However part of my conscious thinks that she will not improve in her ability to ambulate in her gait trainer because we have been at a standstill in her ambulatory progress for about 1 year.
I am concerned about this patient going through a procedure that won't necissarily be functional. I am new to pediatrics and have not experienced too many tendon lengthening procedures. I have been told that they are going to be doing a quad/hamstring procedure. I read in Wheelies that a rectus transfer will help swing phase. Clearing the foot is one of our biggest challenges.
What are your feelings on this procedure and has anybody found it to make the difference?
Thanks
Daniel
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