Kenis V M
Zh Nevrol Psikhiatr Im S S Korsakova. 2012;112(7 Pt 2):29-33.
The objective of the study was to assess factors modulating the efficacy of botulinum toxin injections in the correction of dynamic equinus and equinovarus foot deformities in children with hemiplegic cerebral palsy. The efficacy of treatment was evaluated in 40 children. Clinical data including spasticity assessment by the original Ashworth scale, postural and gate changes were collected. Spasticity grade 4-5 by the Ashworth scale and retraction 90-120 degrees reduce the likelihood of successful correction of equinus contracture. Botulinum injections can be used as basic therapy. In cases of transient contracture more than 120 degrees, combined methods of treatment are recommended. The hindfoot varus less 30 degrees, which can be passively corrected before treatment and in the presence of the positive Coleman block test, more likely needs injection in triceps muscle for correction. If the hindfoot varus is more than 30 degrees and the Coleman block test is negative, the combined treatment is necessary.
本研究的目的是评估调节肉毒杆菌毒素注射治疗偏瘫型脑瘫患儿动态马蹄足和马蹄内翻足畸形疗效的因素。对40名儿童的治疗效果进行了评估。收集了包括采用原始Ashworth量表评估痉挛情况、姿势和步态变化等临床数据。Ashworth量表评定痉挛等级为4 - 5级且背屈90 - 120度会降低马蹄足挛缩成功矫正的可能性。肉毒杆菌注射可作为基础治疗。对于超过120度的短暂性挛缩病例，建议采用联合治疗方法。后足内翻小于30度，在治疗前可被动矫正且科尔曼阻滞试验呈阳性时，更有可能需要注射三头肌进行矫正。如果后足内翻大于30度且科尔曼阻滞试验为阴性，则需要联合治疗。
