COMPARISON OF EFFICACY OF BOTULINUM INJECTION WITH SURGICAL RELEASE IN CEREBRAL PALSY CHILDREN WITH FOOT EQUINUS

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Published: Dec 31, 2021
DOI: https://doi.org/10.54079/jpmi.35.4.2875
Keywords:
, Efficacy, Botulinum Toxin, Surgical Release, Equinus, Cerebral Palsy

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Khalid Iqbal
Department of Orthopaedics, Khyber Teaching Hospital (Medical Teaching Institute) Peshawar-Pakistan.
Mudir Khan
Department of Orthopaedics, Khyber Teaching Hospital (Medical Teaching Institute) Peshawar-Pakistan.
Muhammad Usama
Department of Orthopaedics, Khyber Teaching Hospital (Medical Teaching Institute) Peshawar-Pakistan.
Imran Ali
Department of Orthopaedics, Hayatabad Medical Complex (Medical Teaching Institute) Peshawar-Pakistan.

Abstract

Objective: To compare the efficacy of surgical release and Botulinum Toxin injections for treating foot equinus in Cerebral Palsy (CP) patients.


Methodology: This Quasi-experimental study was conducted in the Orthopedic Department, Khyber Teaching Hospital (KTH) Peshawar-Pakistan. The study enrolled 60 patients from 1st March 2018 to 1st June 2019 via non-probability consecutive sampling. All diagnosed cases of CP with equinus foot of either gender and age between 4-18 years with no previous surgery or botulinum injections and no joint deformity were included; while all patients with myasthenia gravis, neuromuscular junction disease, use of aminoglycoside, and those with dis­continued physiotherapy were excluded. The patients were distributed into two equal groups, group A (botulinum group) and group B (surgery group). The outcome of the interventions in each group was measured based on improvement in Gross Motor Function Measure-66 (GMFM-66). Data was analysed using SPSS v.21.0, descriptive and analytical analysis was conducted where needed.


Results: The mean age of patients was 11.47±4.01 years with male to female ratio of 1.22:1. The right and left foot distribution among the patients was 31 (52%) and 29 (48%) respectively. Botulinum type A (BTX-A) injection resulted in improvement of GMFM-66 score in 27 (90%) patients in group A while the surgical release was effec­tive in 20 (66.7%) patients in group B in terms of improvement in GMFM-66 score.


Conclusion: The study concluded that Botulinum Toxin has much better effectiveness as compared to surgical release in treatment of foot equinus among CP patients.

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1.
Iqbal K, Khan M, Usama M, Ali I. COMPARISON OF EFFICACY OF BOTULINUM INJECTION WITH SURGICAL RELEASE IN CEREBRAL PALSY CHILDREN WITH FOOT EQUINUS. J Postgrad Med Inst [Internet]. 2021 Dec. 31 [cited 2024 Nov. 23];35(4):220-4. Available from: https://jpmi.org.pk/index.php/jpmi/article/view/2875
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Vol. 35 No. 4 (2021): JPMI
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Original Article
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