THERAPEUTIC OPPORTUNITY FOR CHILDREN WITH CONGENITAL MALFORMATIONS DUE TO CEREBRAL PALSY

Infantile Cerebral Palsy (ICP) is a condition characterized by brain damage occurring from prebirth to the age of 5, accounts for approximately 2 out of 1,000 live births with varying degrees of severity. This is one of the leading causes results in mobility impairment in children, accounting for about 30-40% of all children with disabilities. Recently, many pediatric patients with congenital malformations due to cerebral palsy have been successfully treated at the American International Hospital (AIH), bringing hope for rehabilitation, self-care, and community integration for these children.

The most recent case is a child named T.L.G.T ( 11 years old from Vung Tau). Due to a congenital condition characterized by the shortening of the Achilles tendons on both sides, T.L.G.T. has been unable to walk independently for the past 11 years. The child could only walk on tiptoes using the tips of ten toes, and almost all daily activities required assistance from family members. At the Department of Orthopedics - American International Hospital (AIH), after an examination and consultation, various tests and imaging studies, Prof. PhD. Dr. René D. Esser indicated surgical intervention on both legs, lengthening the Achilles tendons using the Z-plasty method, incisional opening the joint capsule behind the ankle, and simultaneously removing the adductor tendons on both sides. The surgery was successfully completed in 60 minutes, resulting in both of the patient’s heels being corrected to a functional position. Post-surgery, the patient was awake and alert with stable vital signs; feet were pink and warm. The patient was discharged after one day of hospitalization for monitoring.



After a one-month post-surgery follow-up, G.T has been able to remove the cast and start walking on new legs. Now, the dream of playing and engaging in sports with peers can become a reality for G.T.



Another case of ICP disease treated by Prof. PhD. Dr. René D. Esser at the American International Hospital is D.T.V (16 years old). Born normally like any other child, but by the age of 3, the ICP disease began to progress, causing T.V’s lower limbs to shorten. Gradually, the hips, knees, and ankles also experienced severe shortenings, preventing the patient from being able to extend knees and heels for walking. At the age of 8, T.V underwent surgery to lengthen the Achilles tendon. It was hoped that this would allow normal walking; however, after the surgery, the feet still could not touch the ground due to insufficient lengthening of the Achilles tendon.

Until the age of 16, D.T.V only met Prof. PhD. Dr. René D. Esser. After undergoing a clinical examination and various tests, Dr. René indicated performing surgery to lengthen the tendons in the knee and ankle. Two weeks after the surgery, the patient returned for a follow-up appointment to have suture removal, all surgical incisions were dry and clean. Currently, the patient is practicing physical therapy to restore function and prevent amyotrophy, with an excellent prognosis.

Prof. PhD. Dr. René D. Esser further stated: “For ICP, contractures can occur in both the arms and legs; however, most patients experience contractures in the lower limbs. Specifically, in the cases of G.T and T.V, they are still able to walk, but due to tight contractures above the hip joint and the Achilles tendon, they cannot place their feet down. If they manage to place their feet down, their knees become bent. Surgery to lengthen the Achilles tendon is the best method to increase the range of motion of the joint, making actions such as standing, sitting, and walking easier. Regarding the timing of surgery, children should undergo surgery early to regain normal or near-normal walking ability. The most challenging part is determining how much tendon lengthening is sufficient. Only experience can provide an answer to this question.





Prof. PhD. Dr. René D. Esser graduated from the Ecole de Médecine de Paris (France) and has participated in teaching at many major universities around the world. With over 40 years of experience, Prof. PhD. Dr. René D. Esser was formerly the head of the orthopedics department at Stanford University (USA), Markgroeningen Hospital (Germany), and Tupua Tamasese Meaole Hospital (Samoa). In Vietnam, Prof. PhD. Dr. René D. Esser is one of the few orthopedic surgeons capable of treating congenital malformations and severe trauma conditions, with specialized strengths in:
 

Since 2019 until now, Dr. René has directly examined and operated many patients with musculoskeletal and motor problems at the American International Hospital (AIH). 

To register for examination and treatment by Prof. PhD. Dr. René D. Esser, please make an appointment online at  https://www.aih.com.vn/bac-sy/esser-rene-daniel-dr or contact the hotline (028) 3910 9999.