Recently, we have needed to make this statement upon the intensive questions coming from our patients.
Muscle release surgeries have been performed for many years and are successful in the correctly selected cases. For this purpose, many surgical techniques have been described in which sufficient joint range of motion is obtained by cutting the muscle or sarcolemma. Muscle release surgery can be performed using closed or open methods. While the open surgeries have been performed with large surgical wounds in the past, nowadays they can be performed with incisions of 2 cm. The closed surgeries provide successful results with smaller surgical wounds in a suitable patient and region. In the above-mentioned Ulzibat method, it is known that closed releases are applied to each part of the body. However, in the application of the Ulzibat method, there is a risk of cutting the subcutaneous and intramuscular vascular nerve structures in some parts of the body. A superficial nerve incision was detected in two patients who were checked after surgery. In the light of all these, we recommend that our patients should be careful when choosing this surgical method.
A postoperative rehabilitation and instrumentation are just as important as surgery. According to the information obtained from patients who have been operated with this method, a postoperative rehabilitation program and instrumentation are not subject to a certain protocol. Another problem is that the comfort of the patient cannot be ensured.
According to our research, there is no extensive acceptable study on the Ulzibat method in the current literature. In the only study that we could find in the scientific literature, it was stated that this method should not be applied for treatment (*).
At this point, the right patient selection and experience is of great importance. After surgery, an expression “It is as good as cotton” does not always mean that the treatment is good. Because our children need the released muscles also for sitting, standing and walking as well. Therefore, prior to treatment, our goal should be to apply an adequate release at the right time.
We, the Ortopediatri Pediatric Orthopedic Academy, can recommend scientific researches which have been accepted by the current modern medicine and have been supported by the experiences, and the treatments in the light of the scientific innovations developing in the world medicine. We believe that treatments that do not have a scientific basis or are inadequate should not be applied to our children. We also think that the Ulzibat method should not be preferred until it has a satisfactory scientific basis.
Please note that not all methods are good.
* Gómez-Andrés D, Pulido-Valdeolivas I, Martín-Gonzalo JA, et al. Evaluación externa de los cambios funcionales y la marcha tras una sesión de miofibrotomía múltiple en escolares con diplejía espástica [External evaluation of gait and functional changes after a single-session multiple myofibrotenotomy in school-aged children with spastic diplegia]. Rev Neurol. 2014;58(6):247–254.