Temelli Yener, Akalan N Ekin
Istanbul Universitesi Istanbul Tip Fakultesi, Ortopedi ve Travmatoloji Anabilim Dali, 34093 Capa, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2009 Mar-Apr;43(2):113-20. doi: 10.3944/AOTT.2009.113.
The knee is the most affected joint in children with cerebral palsy. Flexion contracture of the knee is the cause of crouch gait pattern, instability in stance phase of gait, and difficulties during standing and sitting, and for daily living activities. It may also cause patella alta, degeneration of the patellofemoral joint, and stress fractures of the patella and tibial tubercle in young adults. Children with cerebral palsy may even give up walking due to its high energy demand in the adult period. The purpose of this article is to review the causes of the knee flexion contractures, clinical and radiological evaluations, and treatment principles in children with cerebral palsy. The biomechanical reasons of knee flexion deformity are discussed in detail in the light of previous studies and gait analysis data.
膝关节是脑瘫患儿中受影响最严重的关节。膝关节屈曲挛缩是蹲伏步态模式、步态站立期不稳定、站立和坐立困难以及日常生活活动困难的原因。它还可能导致髌骨高位、髌股关节退变以及年轻成年人的髌骨和胫骨结节应力性骨折。由于成年期能量需求高,脑瘫患儿甚至可能放弃行走。本文的目的是综述脑瘫患儿膝关节屈曲挛缩的原因、临床和影像学评估以及治疗原则。根据以往研究和步态分析数据,详细讨论了膝关节屈曲畸形的生物力学原因。