Piazza S J, Adamson R L, Sanders J O, Sharkey N A
Center for Locomotion Studies, 29 Recreation Building, The Pennsylvania State University, University Park, PA 16802, USA.
Gait Posture. 2001 Dec;14(3):271-8. doi: 10.1016/s0966-6362(01)00143-6.
Moment arms of tibialis anterior (TA) and tibialis posterior (TP) about the subtalar and talocrural joint axes were measured in anatomic specimens both before and after split tendon transfers. These procedures are commonly performed to correct hindfoot varus, a gait deformity that is often seen in patients with cerebral palsy, stroke, and brain injury. Split tendon transfer significantly reduced the inversion moment arms of tibialis anterior and tibialis posterior at all subtalar joint angles except for the most everted position in the case of TA. Changes in subtalar joint moment arms produced by split tendon transfer, especially those seen in TA, were variable, suggesting that the procedure may be susceptible to technical errors, especially related to balancing tensions in the medial and lateral tendon halves. Talocrural joint moment arms of both muscles were preserved following split tendon transfer. This study presents the first measurements of the moment arms of split transferred muscles. These characterizations of the mechanics of split tendon transfer will aid in the planning and assessment of these procedures.
在解剖标本中，分别在肌腱劈开转移术前和术后测量了胫骨前肌（TA）和胫骨后肌（TP）相对于距下关节和踝关节轴的力臂。这些手术通常用于纠正后足内翻，这是一种在脑瘫、中风和脑损伤患者中常见的步态畸形。肌腱劈开转移显著降低了胫骨前肌和胫骨后肌在所有距下关节角度的内翻力臂，但在胫骨前肌的情况下，除了最外翻位置外。肌腱劈开转移引起的距下关节力臂变化，尤其是在胫骨前肌中观察到的变化，是可变的，这表明该手术可能容易受到技术误差的影响，特别是与平衡内侧和外侧肌腱半部的张力有关。肌腱劈开转移后，两块肌肉的踝关节力臂均得以保留。本研究首次测量了劈开转移肌肉的力臂。这些对肌腱劈开转移力学的特征描述将有助于这些手术的规划和评估。
