Sees Julieanne P, Truong Walter H, Novacheck Tom F, Miller Freeman, Georgiadis Andrew G
Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.
Department of Orthopaedics.
J Pediatr Orthop. 2020 Jul;40(6):e498-e503. doi: 10.1097/BPO.0000000000001461.
Limb deformities in ambulatory children with cerebral palsy (CP) are common. The natural history of lower extremity deformities is variable and the impact on gait is managed with many treatment modalities. Effective interventions must consider the underlying pathophysiology, patient-specific goals, and incorporate objective outcome assessment. Evaluation and treatment include observation, tone management multilevel orthopaedic surgery to address muscle contractures and bony deformities, and the use of gait analysis for preoperative and postoperative assessment.
A PubMed search of the orthopaedic literature for studies published between January 2016 and February 2019 was performed. Eligible abstracts included the use of 3-dimensional instrumented gait analysis in the evaluation and treatment of the lower extremities in ambulatory children with CP. Seven hundred twenty abstracts were reviewed, with 84 papers identified as eligible, of which 45 full manuscripts were included for detailed review.
The review summarized recent advances regarding the treatment of torsional alignment, knee deformities and clinical gait evaluation with visual assessment tools compared with instrumented gait analysis.
Gait analysis of ambulatory children with CP remains essential to evaluation and surgical decision-making. Promising results have been reported with the goal of maintaining or reaching a higher level of function and increased endurance.
Level IV-literature review.
能行走的脑瘫（CP）患儿肢体畸形很常见。下肢畸形的自然病程各不相同，对步态的影响可通过多种治疗方式来处理。有效的干预措施必须考虑潜在的病理生理学、患者特定目标，并纳入客观的结果评估。评估和治疗包括观察、肌张力管理、针对肌肉挛缩和骨骼畸形的多级骨科手术，以及使用步态分析进行术前和术后评估。
对2016年1月至2019年2月发表的骨科文献进行PubMed检索。符合条件的摘要包括在能行走的CP患儿下肢评估和治疗中使用三维仪器化步态分析。共审查了720篇摘要，确定84篇论文符合条件，其中45篇全文纳入详细审查。
该综述总结了与仪器化步态分析相比，使用视觉评估工具治疗扭转对线、膝关节畸形和临床步态评估方面的最新进展。
对能行走的CP患儿进行步态分析对于评估和手术决策仍然至关重要。已有报道称，在维持或达到更高功能水平和增加耐力方面取得了有希望的结果。
IV级——文献综述。
