Beals R K
Oregon Health Sciences University, Department of Orthopaedics and Rehabilitation, Portland 97201, USA.
Dev Med Child Neurol. 2001 Dec;43(12):802-5. doi: 10.1017/s0012162201001451.
Results of surgery to correct fixed flexion contracture of the knee and improve voluntary knee extension in 39 knees in 20 children (11 females, 9 males; mean age 12 years 8 months, age range 5 to 20 years) with cerebral palsy were analyzed. All patients had neuromotor disease and 18 children had spastic diplegia or quadriplegia. All patients could initiate voluntary knee extension but lacked full passive extension. Five patients (10 knees) were free walkers with a mean motor severity index of 19 and mean fixed knee contracture of 20 degrees. Fifteen patients (29 knees) were not free walkers and 13 were wheelchair ambulators. They had a mean motor severity index of 8 and mean fixed knee contractures of 30 degrees. Surgical procedures included various combinations of hamstring lengthening and/or posterior capsulotomy to allow free passive knee extension, with or without quadriceps mechanism shortening, to enhance voluntary extension. The best results were in patients who had hamstring lengthening, posterior capsulotomy, and quadriceps mechanism shortening.
分析了20例（11名女性，9名男性；平均年龄12岁8个月，年龄范围5至20岁）脑瘫患儿39个膝关节纠正固定性屈膝挛缩并改善主动膝关节伸展的手术结果。所有患者均患有神经运动疾病，18名儿童患有痉挛性双侧瘫或四肢瘫。所有患者均可主动开始膝关节伸展，但缺乏完全被动伸展。5例患者（10个膝关节）为自由行走者，平均运动严重程度指数为19，平均固定膝关节挛缩为20度。15例患者（29个膝关节）不是自由行走者，13例为轮椅使用者。他们的平均运动严重程度指数为8，平均固定膝关节挛缩为30度。手术方法包括各种组合的腘绳肌延长和/或后关节囊切开术，以实现自由被动膝关节伸展，有或没有股四头肌机制缩短，以增强主动伸展。效果最佳的是接受了腘绳肌延长、后关节囊切开术和股四头肌机制缩短的患者。
