Barnes M J, Herring J A
Texas Scottish Rite Hospital for Crippled Children, Dallas 75219.
J Bone Joint Surg Am. 1991 Jun;73(5):734-8.
Twenty patients who had a varus deformity of the foot secondary to spastic cerebral palsy had twenty-two operations involving combined split anterior tibial-tendon transfer and intramuscular lengthening of the posterior tibial tendon, with and without concomitant lengthening of the Achilles tendon. Preoperatively, all patients had had a dynamic varus deformity of the hindfoot and adduction of the forefoot in both the stance phase and the swing phase of gait. At an average follow-up of 6.2 years (range, 2.3 to 8.8 years), there were fourteen excellent, four good, and four poor clinical results. Two patients who had a fixed varus deformity of the hindfoot and one patient who had a very weak anterior tibial muscle had a poor result. We concluded that the combined procedure is effective for correction of a flexible varus deformity of the foot in patients who have spastic cerebral palsy.
20例因痉挛性脑瘫继发足部内翻畸形的患者接受了22次手术，手术包括联合胫前肌腱劈开转移和胫后肌腱肌肉内延长术，部分患者同时进行了跟腱延长术。术前，所有患者在步态的站立期和摆动期均存在后足动态内翻畸形和前足内收。平均随访6.2年（范围2.3至8.8年），临床结果为14例优、4例良、4例差。2例后足固定内翻畸形患者和1例胫前肌非常薄弱的患者结果较差。我们得出结论，该联合手术对于纠正痉挛性脑瘫患者足部的柔韧性内翻畸形有效。
