Reimers J
Clinic for Cerebral Palsy and Orthopaedic Department, Rigshospitalet, University of Copenhagen, Denmark.
Clin Orthop Relat Res. 1990 Apr(253):30-4.
In a recent study, children with spastic cerebral palsy (median age, five years) were examined before and up to a median of 14 months after 52 operations involving elongation of the tendo Achillis or aponeurotomy of the gastrocnemius. On removal of the cast four weeks postoperatively, strength in the dorsiflexors had increased by more than 50%, as evaluated by the ability to raise a weight from a scale. Postoperative function was correlated with preoperative function. Strength had increased more than 200% by 14 months postoperatively, with no instance of excessive lengthening of the triceps. In 13 cases, the dorsiflexors had been without function preoperatively. Two of those cases again lost the dorsiflexor function achieved postoperatively, when dynamic shortening recurred after one year. The study thus confirms the view that antagonist function improves when spasticity in the agonist is reduced by tendon lengthening.
在最近一项研究中，对患有痉挛性脑瘫的儿童（中位年龄5岁）在52例跟腱延长术或腓肠肌腱膜切开术后进行术前及术后长达14个月（中位时间）的检查。术后四周拆除石膏时，通过从秤上抬起重物的能力评估，背屈肌力量增加了50%以上。术后功能与术前功能相关。术后14个月时力量增加超过200%，未出现三头肌过度延长的情况。在13例病例中，背屈肌术前无功能。其中2例在术后获得的背屈肌功能在术后一年出现动态缩短时再次丧失。该研究因此证实了这样一种观点，即当通过肌腱延长减少主动肌的痉挛时，拮抗肌功能会改善。
