Handelsman John E, Weinberg Jacob, Corso Salvatore
Division of Pediatric Orthopaedic Surgery, Schneider Children's Hospital, New Hyde Park, New York, USA.
J Pediatr Orthop B. 2007 May;16(3):185-8. doi: 10.1097/BPB.0b013e32801124c1.
Toe flexor tightness becomes apparent in the plantigrade attitude achieved by isolated tendoachilles lengthening in cerebral palsy. This frequently persists, resulting in abnormal weight-bearing on the tips of the toes. To address this problem, at the time of limited tendoachilles lengthening, we performed Z-lengthenings of the flexor hallucis longus and the flexor digitorum longus tendons above the medial malleolus, preserving the pulley mechanism. From January 1998 to October 2001, 41 children (74 feet) with cerebral palsy underwent lengthening of the tendoachilles and long toe flexor tendons. The mean age at surgery was 7 years. The correction achieved was successfully maintained long-term, permitting a normal heel-metatarsal head weight-bearing pattern. Lengthening of the long toe flexors, in conjuction with tendoachilles lengthening, is an effective means of achieving a balanced foot in cerebral palsy.
在脑性瘫痪患者中，通过孤立性跟腱延长术达到的足底位姿势下，趾屈肌紧张变得明显。这种情况常常持续存在，导致足趾尖异常负重。为了解决这个问题，在进行有限的跟腱延长术时，我们在内踝上方对拇长屈肌腱和趾长屈肌腱进行Z形延长，保留滑车机制。从1998年1月至2001年10月，41例（74足）脑性瘫痪患儿接受了跟腱和长趾屈肌腱延长术。手术时的平均年龄为7岁。所实现的矫正长期成功维持，允许正常的足跟 - 跖骨头负重模式。长趾屈肌延长术与跟腱延长术相结合，是在脑性瘫痪中实现足部平衡的有效方法。
