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[婴儿脑性瘫痪中的屈膝和伸膝痉挛。旨在改善功能的手术及其效果]

[Knee-bending and -stretching-spastic in infant cerebral palsy. Surgery aimed at functional improvement and its results].

作者信息

Döderlein L, Metaxiotis D

机构信息

Abteilung Orthopädie und Rehabilitation, Stiftung Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.

出版信息

Orthopade. 2004 Oct;33(10):1138-51. doi: 10.1007/s00132-004-0682-8.

Abstract

Any treatment of disorders of the knee in patients with cerebral palsy is a complex task in terms of indications and surgical technique. Surgical management has the potential to considerably improve function in walkers as well as tetraparetic patients. The close functional relationship between the knee joint and the adjacent hip and ankle joints requires an integrated view. An increased anterior pelvic tilt aggravates any shortening of the hamstring muscles. An equinus foot deformity increases knee extensor movement. When evaluating postoperative results, it is never sufficient to indicate the postoperative range of motion only. Instead, functional evaluation criteria complemented by instrumented gait analysis must be used to define the results more quickly and to uncover postoperative problems.

摘要

对于脑瘫患者的膝关节疾病,无论从适应症还是手术技术方面来看,任何治疗都是一项复杂的任务。手术治疗有可能显著改善能够行走的患者以及四肢轻瘫患者的功能。膝关节与相邻的髋关节和踝关节之间密切的功能关系需要综合考量。骨盆前倾增加会加重腘绳肌的任何缩短情况。马蹄足畸形会增加膝关节伸展运动。在评估术后结果时,仅指出术后活动范围是远远不够的。相反,必须使用辅以仪器化步态分析的功能评估标准,以便更快地界定结果并发现术后问题。

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