Feldkamp M, Denker P
Orthopädische Universitätsklinik, Münster, Federal Republic of Germany.
Arch Orthop Trauma Surg. 1989;108(4):225-30. doi: 10.1007/BF00936205.
Twenty cerebral palsy patients who had undergone soft-tissue surgery at the hip (adductor tenotomy, medial lengthening of the hamstrings) were compared with a matched group of another 20 patients with a similar age range and findings and with additionally performed iliopsoas release, 2 or more years after surgery. Extension deficits of the hip did not improve with the addition of iliopsoas release. Internal rotation deformities showed equal improvement in both groups; the influence of the iliopsoas procedure was not significant. Adduction deformities, as documented on roentgenograms of the hip, showed significant improvement, however. Postural anomalies were not essentially influenced by iliopsoas release. Hip dislocations and subluxations, as assessed by the CE angles, were positively influenced by additional iliopsoas release; however, more effective improvement was obtained with ischiocrural elongation.
对20例接受过髋关节软组织手术(内收肌切断术、腘绳肌内侧延长术)的脑瘫患者与另一组年龄范围和病情相似且额外进行了髂腰肌松解术的20例匹配患者进行了术后2年或更长时间的比较。增加髂腰肌松解术后,髋关节伸展功能障碍并未改善。两组患者的内旋畸形改善程度相同;髂腰肌手术的影响不显著。然而,根据髋关节X线片记录,内收畸形有显著改善。姿势异常基本上不受髂腰肌松解术的影响。通过CE角评估,髋关节脱位和半脱位受到额外髂腰肌松解术的积极影响;然而,坐骨神经延长术能取得更有效的改善效果。