- Release Date 01 Jan 2009
- Team Members / Doctors Portinaro N, Panou A, Gagliano N, Pelillo F.
- Category Cerebral Palsy, Pediatric Orthopedics
ABOUT THIS PROJECT
Prof. Nicola Portinaro has been adopting a unique treatment protocol for children affected by neuromotor disorders since 2004. It is called Early Multilevel Minimally-invasive Approach. A study of this approach adopted for developmental dysplasia of the spastic hip in cerebral palsy was published in 2009 in the magazine Hip International.
It is a Minimally-invasive and Early Multilevel surgical approach to recover the motor function of children with neuro-motor diseases and reduce the evolution of these diseases in structured musculotendinous and osteoarticular deformities.
This approach is applied to all the motor districts such as knee, ankle, foot and also to the whole upper limb.
Until a few years ago, surgery aimed to lengthen tendons and muscles that over time contracted again.
Now we try to avoid surgery on noble tissues such as tendon and muscle but we act by “sliding” them one on the other to obtain a biomechanical elongation-adaptation.
This leads to an improvement of the force and power curves and allows to exploit muscles that work incorrectly and inadequately.
After a careful clinical evaluation, it is possible to chart a specific treatment plan which is optimized for every child.
The clinical assessment is aimed to determine:
- the range of movement of each joint
- the strength and resistance of the muscles
- the ability to perform a specific and precise voluntary movement
- an instrumental evaluation of the deformities of the musculoskeletal system
Furthermore, in collaboration with the Divieti laboratory of the Politecnico, University of Milan, young patients are also studied from a dynamic point of view, using the most recent kinetics and kinematics gait analysis. The walk on platforms that allow quantifying the movement and the strength of the various joints and muscles and the extent of the deformities.
In this way, it is possible to get a complete clinical picture of the motor potential. Thanks to this analysis it is possible to perform a targeted surgery that allows improving the motor potential of children in a substantial and radical way.