Yngve D A, Chambers C
Shriners Hospital for Crippled Children, Houston, Texas, USA.
J Pediatr Orthop. 1996 Nov-Dec;16(6):759-64. doi: 10.1097/00004694-199611000-00011.
An evaluation of ankle function in gait after 22 Vulpius lengthenings of the gastrocnemius fascia and 27 Z-lengthenings of the Achilles tendon was performed in 33 ambulatory cerebral palsy patients. Simultaneous hip or knee surgeries or both were performed in most instances. Gait analysis including ankle motion, moment, and power data was obtained before surgery and approximately 1 year after. The ankle moments were improved and approached normal in the majority of cases in each group. There were no significant differences between the Vulpius and Z-lengthening groups at follow-up in any of the parameters. There were significant differences between the initial and follow-up measurements of each group. The Vulpius group showed a notable presence of abnormal midstance work initially and had a significant decrease at follow-up. The Z-lengthening group showed a notable presence of equinus and a notable lack of push-off work initially and had a significant decrease in equinus and a significant increase in push-off work at follow-up. Each procedure appears to give satisfactory results because the follow-up results were similar.
对33例门诊脑性瘫痪患者进行了评估，这些患者接受了22次腓肠肌筋膜Vulpius延长术和27次跟腱Z形延长术，以观察术后步态中的踝关节功能。多数情况下同时进行了髋关节或膝关节手术，或两者都做了。在手术前及术后约1年获取了包括踝关节运动、力矩和功率数据的步态分析结果。每组大多数病例的踝关节力矩均有改善并接近正常。随访时，Vulpius延长组和Z形延长组在任何参数上均无显著差异。每组术前和随访测量结果之间存在显著差异。Vulpius延长组最初在摆动中期工作存在明显异常，随访时显著减少。Z形延长组最初明显存在马蹄足且明显缺乏蹬离工作，随访时马蹄足显著减少，蹬离工作显著增加。由于随访结果相似，每种手术似乎都能给出满意的结果。
