Blasier R D, White R
Division of Pediatric Orthopaedics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock 72202-3591, USA.
J Pediatr Orthop. 1998 May-Jun;18(3):299-303.
Heel-cord lengthening is commonly performed for contractures in neuromuscular disease. Immobilization after this procedure has ranged from 3 to 8 weeks. A three-part study was performed to determine adequate length of immobilization. Sixteen rabbits had surgical transection of the right gastrocsoleus tendon in phase 1. Healing was allowed for 1, 3, 5, or 7 weeks. Tendons were then studied by magnetic resonance imaging (MRI), mechanical testing, or histologic section. A marker for healing was determined by MRI. Seven children underwent percutaneous sliding heel-cord lengthening (PSHCL) in phase 2. Healing was studied by MRI. Based on the marker from phase 1, adequate healing occurred at 3 weeks. Thirty-one children underwent PSHCL for neuromuscular contracture in phase 3. Cast immobilization was maintained for 3 weeks (group 1) and for >3 weeks (group 2). There was no evidence of rupture or progressive lengthening after cast removal in either group.
跟腱延长术常用于治疗神经肌肉疾病导致的挛缩。该手术后的固定时间为3至8周。进行了一项分为三个部分的研究以确定合适的固定时长。在第一阶段，16只兔子接受了右腓肠肌肌腱的手术横断。分别让其愈合1、3、5或7周。然后通过磁共振成像（MRI）、力学测试或组织学切片对肌腱进行研究。通过MRI确定愈合的标志物。在第二阶段，7名儿童接受了经皮滑动跟腱延长术（PSHCL）。通过MRI研究愈合情况。根据第一阶段的标志物，3周时出现了充分愈合。在第三阶段，31名儿童因神经肌肉挛缩接受了PSHCL。一组（第1组）石膏固定维持3周，另一组（第2组）石膏固定维持超过3周。两组在拆除石膏后均未出现断裂或渐进性延长的迹象。
