脑性瘫痪非卧床儿童股直肌远端转移手术结果的预测因素

Predictors of outcome of distal rectus femoris transfer surgery in ambulatory children with cerebral palsy.

作者信息

Rethlefsen Susan A, Kam Galen, Wren Tishya A L, Kay Robert M

机构信息

Childrens Orthopaedic Center, Childrens Hospital Los Angeles, CA 90027, USA.

出版信息

J Pediatr Orthop B. 2009 Mar;18(2):58-62. doi: 10.1097/BPB.0b013e3283298981.

DOI:10.1097/BPB.0b013e3283298981

PMID:19282786

Abstract

The objective of this study was to identify the predictors of outcome of distal rectus femoris transfer in cerebral palsy. Preoperative and postoperative gait data for 81 patients were examined, focusing on knee flexion/extension range. Outcome was 'good' for 46 patients and 'poor' for 35. The poor outcome group had no improvement in knee range because of increased crouch postoperatively. Outcome was unrelated to quadriceps strength, crouch, velocity, or type of cerebral palsy. Gross Motor Function Classification System was predictive of outcome, with poor results in all level IV patients (P< or =0.008). In conclusion, Gross Motor Function Classification System IV patients may not benefit from distal rectus femoris transfer because of increased postoperative crouch.

摘要

本研究的目的是确定脑瘫患者股直肌远端转移术预后的预测因素。对81例患者术前和术后的步态数据进行了检查，重点关注膝关节屈伸范围。46例患者的预后为“良好”，35例为“不佳”。预后不佳组由于术后蹲伏增加，膝关节活动范围没有改善。预后与股四头肌力量、蹲伏、速度或脑瘫类型无关。粗大运动功能分类系统可预测预后，所有IV级患者的结果均较差（P≤0.008）。总之，由于术后蹲伏增加，粗大运动功能分类系统IV级患者可能无法从股直肌远端转移术中获益。