Estudo clínico do quadril não tratado na tetraparesia espástica

Objetivo: Avaliar quadris de pacientes com tetraparesia espastica considerando a gravidade das deformidades articulares, a idade e a escoliose. Metodos: Realizamos um estudo descritivo transversal de 40 pacientes (um a 17 anos); 21 (52,5 por cento) do sexo feminino e 19 (47,5 por cento) do masculino em pacientes da Associacao Cruz Verde; 19 (47,5 por cento) apresentaram prematuridade, 26 (65,0 por cento) anoxia, quatro (10,0 por cento) meningite, 10 (25,0 por cento) hidrocefalia e 15 (37,5 por cento) microcefalia; 38 (95,0 por cento) apresentavam espasticidade, um (2,5 por cento) atetose e um (2,5 por cento) o padrao misto; 28 (70,0 por cento) apresentavam tetraparesia e 12 (30,0 por cento) dupla hemiparesia. Nenhum paciente deambulava, 38 (95,0 por cento) foram classificados como GFMCS V e dois (5,0 por cento) como IV. Consideramos dois grupos, conforme a necessidade ou nao do tratamento cirurgico dos quadris pelo risco de luxacao e dor. Utilizamos os testes de Thomas, abducao brusca e Nelaton-Galeazzi. A escoliose foi avaliada pela simetria do tronco e gibosidade. Resultados: Observamos correlacao entre a escoliose e a positividade do teste da abducao brusca. Nao houve correlacao entre a idade e a contratura dos quadris. Nao houve diferenca entre os tipos topograficos e a contratura do quadril. Conclusoes: Nao encontramos correlacao entre a idade e o grau de contratura articular; pacientes com escoliose apresentaram maior comprometimento da abducao do quadril.(AU) Objective: To evaluate CP patients considering the hip joint and analyzing the relation between severity, age and scoliosis. Methods: A transversal descriptive study was performed in 40 patients (1 to 17 y.o.), 21 (52,5 percent) female and 19 (47,5 percent) male from Cruz Verde Association; 19 (47,5 percent) had history of prematurity; 26 (65,0 percent) with anoxia; meningitis in 4 (10 percent), hydrocephalus in 10(25,0 percent); microcephalus in 15 (37,5 percent). From the total 38 (95,0 percent) presented spasticity, 1 (2,5 percent) athetoid and 1 (2,5 percent) mixed. According to topographic classification 28 (70,0 percent) presented tetraparesis and 12 (30,0 percent) double hemiparesis. All of them are non-ambulators and 38 (95,0 percent) were classified as GFMCS V and 2 (5,0 percent) were level IV. The patients were divided in two groups (with or without indications for hip surgical treatment). The hips were analysed by Thomas, abduction, and Nelaton-Galeazzi tests. The scoliosis was clinically analysed considering trunk symmetry and dorsal hump. Results: We observed positive correlation between the patients’ scoliosis and hip flexion contracture. There was no difference between the patients’ age and and hip flexion contracture. There was no difference between topographic types and hip contractures. Conclusions: We did not find positive correlation between patients’ age and hip contractures; patients with scoliosis present worse hip abduction compromise.(AU)