Edwards P, Hsu J
West Virginia University, Morgantown 26506-9196.
Foot Ankle. 1993 Jul-Aug;14(6):335-8. doi: 10.1177/107110079301400605.
During a 4-year period, split anterior tibial tendon transfer (SPLATT) was performed on 42 adults with cerebrospastic equinovarus deformity. Twenty-one patients (24 feet) had a minimum 1-year follow-up, which included detailed documentation of foot appearance position and function as well as ambulatory status. Thirteen patients were male and 8 were female. Average age of the patients was 41 years. Seventeen patients were independent ambulators with orthoses, one was a maximally assisted ambulator. Three patients with spastic quadriparesis were nonambulatory. All patients had uniform surgical technique and postoperative management. This paper presents the results of SPLATT and identifies risk factors for poor surgical outcomes. After an average follow-up of 39 months, 83% of the feet were rated as having good or excellent results. All ambulatory patients had improved gait and 35% of them were able to discontinue their orthoses. Poor surgical outcomes were associated with nonambulatory status in brain injured patients (P = .018). Salvage of failed SPLATT is discussed.
在4年的时间里，对42例患有脑瘫痉挛性马蹄内翻畸形的成年人进行了胫前肌腱劈开转移术（SPLATT）。21例患者（24只脚）进行了至少1年的随访，包括对足部外观、位置、功能以及行走状态的详细记录。其中13例为男性，8例为女性。患者的平均年龄为41岁。17例患者借助矫形器可独立行走，1例为最大程度辅助行走者。3例痉挛性四肢瘫患者无法行走。所有患者均采用统一的手术技术和术后管理。本文介绍了胫前肌腱劈开转移术的结果，并确定了手术效果不佳的风险因素。平均随访39个月后，83%的足部被评定为效果良好或极佳。所有可行走的患者步态均有改善，其中35%的患者能够停用矫形器。手术效果不佳与脑损伤患者的非行走状态相关（P = 0.018）。本文还讨论了失败的胫前肌腱劈开转移术的补救方法。
