Wright J G, Menelaus M B, Broughton N S, Shurtleff D
Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut.
J Pediatr Orthop. 1991 Nov-Dec;11(6):725-30. doi: 10.1097/01241398-199111000-00005.
The natural history of knee contracture was determined in a prospective study of 850 myelomeningocele (MM) patients, ranging in age from neonate to 23 years, excluding patients after knee surgery. Fixed flexion contracture of 10 degrees at birth decreased by age 9 months but increased thereafter if the patient's MM level was higher than L3. In the thoracic/L1-L3 level patients, the mean fixed flexion contracture was 18 degrees with and 17 degrees without knee flexor spasticity. Range of knee flexion remained at 126 degrees until age 3 years, and decreased thereafter if the patient's MM was higher that L3. This study demonstrates that muscle imbalance and spasticity play a minimal role in development of knee contracture.
在一项对850例脊髓脊膜膨出（MM）患者的前瞻性研究中确定了膝关节挛缩的自然病史，这些患者年龄从新生儿到23岁，不包括接受膝关节手术后的患者。出生时10度的固定屈曲挛缩在9个月龄时有所减轻，但如果患者的MM水平高于L3，则此后会增加。在胸段/L1-L3水平的患者中，有膝屈肌痉挛者平均固定屈曲挛缩为18度，无膝屈肌痉挛者为17度。膝关节屈曲范围在3岁前保持在126度，此后如果患者的MM高于L3则会减小。这项研究表明，肌肉失衡和痉挛在膝关节挛缩的发展中起的作用极小。
