Lai K A, Lin C J, Su F C
Orthopaedic Department, National Cheng Kung University, Tainan City, Taiwan ROC.
J Formos Med Assoc. 1997 Sep;96(9):740-4.
Comprehensive gait analysis is valuable in understanding the performance of patients with lower limb disorders. The gait pattern of adult patients with untreated congenital dislocation of the hip (CDH) has not yet been reported. We studied the gait pattern in nine women (mean age 31.4 years) with Crows group IV CDH. Six had unilateral and three had bilateral involvement. They were not treated during childhood and had no pain at the time of study. A control group comprised 15 normal female subjects of the same age group. Gait was studied using a motion-analysis system, force plateforms, and computer calculation during level walking. Common abnormal gait patterns seen in patients with both unilateral and bilateral CDH were slower walking velocity, which was due to a shorter stride length, less forward tilting of the pelvis, insufficient flexion, and excessive internal rotation of the hips. The patients with unilateral CDH had a shorter step length, lower pelvis, a lateral shift of the ground reaction force, decreased maximum adduction moments of the hip and knee on the diseased side, and increased maximum adduction moments of the hip and knee on the unaffected side. This asymmetry may have been due to leg length inequality. Thus, correlation of the leg length discrepancy may be important for unilateral CDH patients in improving their gait.
全面的步态分析对于理解下肢疾病患者的表现很有价值。未经治疗的成年先天性髋关节脱位（CDH）患者的步态模式尚未见报道。我们研究了9名患有克劳氏IV型CDH的女性（平均年龄31.4岁）的步态模式。其中6人单侧受累，3人双侧受累。她们在儿童时期未接受治疗，研究时无疼痛。对照组由15名同年龄组的正常女性受试者组成。在水平行走过程中，使用运动分析系统、测力平台和计算机计算对步态进行研究。单侧和双侧CDH患者常见的异常步态模式包括步行速度较慢，这是由于步幅较短、骨盆前倾减少、髋关节屈曲不足和过度内旋所致。单侧CDH患者的步长较短、骨盆较低、地面反作用力向外侧偏移、患侧髋关节和膝关节的最大内收力矩降低，而未受影响侧髋关节和膝关节的最大内收力矩增加。这种不对称可能是由于腿长不等所致。因此，腿长差异的相关性对于单侧CDH患者改善步态可能很重要。
