Smetana V, Schejbalová A
Ortopedická klinika dĕtí a dospĕlých 2. lékarské fakulty KU, Praha.
Acta Chir Orthop Traumatol Cech. 1993;60(4):225-31.
The authors evaluate the results of prolongation of the flexors of the knee joint in 175 patients with a flexed position of the knee joint associated with the spastic form of cerebral palsy. They draw attention to the interrelationship of the position of the lower extremities in the area of the sole, knee and hip joint and emphasize the necessity of correct assessment of primary contractures. They emphasize also the evaluation of correct concurrent function of flexors and extensors of the knee and their balanced functioning. The authors prefer a single surgical operation in combined affections of the lower extremities to the system of so-called minor steps. They emphasize the importance of postoperative rehabilitation and prosthetic support. In the authors' opinion surgery of the knee joint in manifestations of cerebral palsy on the lower extremities is the most controversial area associated with the highest percentage of failures and complications. Contrary to data in the literature, they refute the necessity of capsulotomy of the knee joint and recommend their own modification how to treat severe forms of genu flectum spasticum.
作者评估了175例因痉挛型脑瘫导致膝关节屈曲的患者中延长膝关节屈肌的结果。他们提请注意下肢在足底、膝关节和髋关节区域的位置之间的相互关系，并强调正确评估原发性挛缩的必要性。他们还强调了评估膝关节屈肌和伸肌的正确协同功能及其平衡功能。与所谓的小步骤系统相比，作者更倾向于对下肢合并病变进行单次手术。他们强调术后康复和假肢支持的重要性。在作者看来，下肢脑瘫表现中的膝关节手术是最具争议的领域，失败和并发症的发生率最高。与文献中的数据相反，他们驳斥了膝关节囊切开术的必要性，并推荐了他们自己治疗重度痉挛性膝屈曲的改良方法。
