Root L, Miller S R, Kirz P
Hospital for Special Surgery, New York Hospital-Cornell University Medical College, New York City 10021.
J Bone Joint Surg Am. 1987 Oct;69(8):1133-9.
The results of fifty-seven posterior tibial-tendon transfers through the interosseous membrane to the dorsum of the foot that were performed in fifty-one patients who had cerebral palsy, and who were followed for a mean of 9.3 years (range, five to twenty-six years), were evaluated in terms of pattern of gait, alignment of the foot, formation of callus on the sole of the foot, and requirements for bracing. A good or excellent result was achieved in twenty-seven of thirty feet in the hemiplegic patients, twelve of sixteen feet in the paraplegic patients, and two of eleven feet in the quadriplegic patients. We found that in order for the tendon transfer to be successful the foot had to be passively correctable to at least a neutral position and that the tendon had to be passed superficial to the extensor retinaculum and inserted into the lateral cuneiform bone. The heel cord should be lengthened before the tendon transfer.
对51例脑瘫患者进行的57次经骨间膜将胫后肌腱转移至足背的手术结果进行了评估，这些患者平均随访9.3年（范围为5至26年），评估内容包括步态模式、足部对线、足底胼胝形成以及支具需求。偏瘫患者30只脚中有27只取得了良好或优异的结果，截瘫患者16只脚中有12只，四肢瘫患者11只脚中有2只。我们发现，为使肌腱转移成功，足部必须能够被动矫正至至少中立位，并且肌腱必须从伸肌支持带浅面穿过并插入外侧楔骨。在进行肌腱转移之前应延长跟腱。
