Kay Robert M, Rethlefsen Susan A, Kelly John P, Wren Tishya A L
Children's Orthopaedic Center, Children's Hospital Los Angeles and the Department of Orthopaedics, University of Southern California, Los Angeles, California 90027, USA.
J Pediatr Orthop. 2004 Jan-Feb;24(1):59-62. doi: 10.1097/00004694-200401000-00011.
Fifty-six patients who underwent 94 distal rectus femoris transfers and pre- and postoperative gait analyses were retrospectively reviewed. The patients were divided into three groups based on pre- and postoperative Duncan-Ely tests. Group A (34 limbs) had positive tests both before and after surgery. Group B (46 limbs) had positive tests before surgery and negative tests after surgery. Group C (13 limbs) had negative tests both before and after surgery. One limb had a negative test before surgery and a positive test after surgery and was not included in any group. Knee arc increased significantly in both groups with positive preoperative Duncan-Ely tests (groups A and B), but not in the group with negative preoperative tests (group C). The timing of peak knee flexion in swing improved in all groups, but the change was smaller and not statistically significant in the group with negative preoperative tests (group C). The findings of the current study indicate that the Duncan-Ely test may be a helpful predictor of outcome in children for whom distal rectus femoris transfer is being considered. Caution should be exercised when patients have weak quadriceps and a negative Duncan-Ely test before surgery, particularly when concurrent calf lengthening procedures are planned.
回顾性分析了56例行94次股直肌远端转移术及术前和术后步态分析的患者。根据术前和术后的邓肯 - 伊利试验，将患者分为三组。A组（34条肢体）手术前后试验均为阳性。B组（46条肢体）术前试验阳性，术后试验阴性。C组（13条肢体）手术前后试验均为阴性。有1条肢体术前试验阴性，术后试验阳性，未纳入任何一组。术前邓肯 - 伊利试验阳性的两组（A组和B组）膝关节活动弧度均显著增加，而术前试验阴性的组（C组）则未增加。所有组在摆动期膝关节最大屈曲时间均有改善，但术前试验阴性的组（C组）变化较小且无统计学意义。本研究结果表明，邓肯 - 伊利试验可能有助于预测考虑行股直肌远端转移术儿童的手术效果。对于术前股四头肌无力且邓肯 - 伊利试验阴性的患者，尤其是计划同时进行小腿延长手术时，应谨慎行事。
