Abstract
Changes in hip joint in patients with children brain palsy are secondary and originate from functional condition of the joint muscles. M. rectus femoris influenced anteflexion position of pelvis, position of patellae and its luxation influence becomes manifest only afterwards.
Interventions on muscles belong to basal ones in patients with children brain palsy. In combined tonometry of adductors and m. rectus femoris or also medial hamstrigs the authors succeeded in preventing lateral migration of hip joints at the age of 6 years in 45.7% of patients.
In the years 1996 - 2005 the combined tonometry of adductors and m. rectus femoris was performed 524 times. In the years 1992 - 2005 the authors indicated transposition of lig.patellae in distomedial direction 79 times for a high position of patella, lafage of lig.patellae was performed in children between 8 and 13 years of age 34 times.
Clinical and X-ray examination was performed with a time lapse of two and six months after the operation, respectively. Distalization of m.rectus femoris attenuates anteflexion position of pelvis and, in combination with tenotomy of adductors or prolongation of m.iliopsoas, may prevent progression of lateral migration of the hip joint.
The tactics of flexor muscles prolongation with possible distalization of patella in indicated cases in verticalized patients improved the stand and walking in the patient.