脚踝
步态
医学
痉挛性双瘫
脑瘫
双瘫
步态分析
物理医学与康复
痉挛的
物理疗法
外科
作者
Dimitrios Metaxiotis,Sebastian I. Wolf,L. Doederlein
出处
期刊:The journal of bone and joint surgery
[British Editorial Society of Bone and Joint Surgery]
日期:2004-01-01
卷期号:86-B (1): 102-109
被引量:25
标识
DOI:10.1302/0301-620x.86b1.13689
摘要
We treated 20 children (40 limbs) with diplegic cerebral palsy who could walk by multilevel soft tissue operative procedures including conversion of the biarticular semitendinosus and gastrocnemius to monoarticular muscles. The mean age at surgery was 11.5 years (5.6 to 17.0). All patients underwent clinical and radiological examination and three-dimensional instrumented gait analysis before and at a mean of 3.1 years (2.0 to 4.5) after surgery. The passive range of movement at the ankle, knee and hip showed improvement at follow-up. Kinematic parameters indicated a reduced pelvic range of movement and improvement of extension of the knee in single stance after operation (p < 0.0001). However, postoperative back-kneeing was detected in five of the 40 limbs. The kinetic studies showed that the power of the hamstrings and plantar flexors of the ankle was maintained while the maximum knee extensor moment during stance was reduced. The elimination of knee flexor activity of semitendinosus and gastrocnemius combined with transfer of distal rectus femoris led to an improvement in gait as confirmed by gait analysis.
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