Corry I S, Cosgrove A P, Duffy C M, Taylor T C, Graham H K
Department of Orthopaedic Surgery, Royal Belfast Hospital for Sick Children and Musgrave Park Hospital, Belfast, UK.
Gait Posture. 1999 Dec;10(3):206-10. doi: 10.1016/s0966-6362(99)00037-5.
Hamstring injection of Botulinum toxin A (BtA) may have a role in the conservative management of flexed knee gait in cerebral palsy or in simulating the effect of surgery. Ten children who were likely to require future hamstring lengthening were injected. Short term outcome was assessed by clinical examination and 3-D gait analysis. Mean popliteal angle decreased by 16 degrees and maximum knee extension in stance increased by 8 degrees, the latter relapsing by 12 weeks. Mean pelvic tilt tended to increase suggesting that isolated hamstring weakening be approached with caution. Energy cost of walking was not significantly changed in six of the ten patients. A small increase in knee extension in stance was often associated with patient satisfaction. There are theoretical grounds for expecting an associated increased longitudinal muscle growth after BtA injection.
注射肉毒杆菌毒素A（BtA）至腘绳肌可能在保守治疗脑瘫屈膝步态或模拟手术效果方面发挥作用。对十名可能需要未来进行腘绳肌延长术的儿童进行了注射。通过临床检查和三维步态分析评估短期结果。平均腘窝角减小了16度，站立时最大膝关节伸展增加了8度，后者在12周时复发。平均骨盆倾斜度有增加趋势，提示单独减弱腘绳肌时应谨慎。十名患者中有六名的步行能量消耗没有显著变化。站立时膝关节伸展的小幅增加通常与患者满意度相关。从理论上讲，预计注射BtA后会伴随纵向肌肉生长增加。
