Rectus Femoris Transfer Versus Rectus Intramuscular Lengthening for the Treatment of Stiff Knee Gait in Children With Cerebral Palsy
| Autor: | Allison Scott, Douglas Barnes, Elroy Sullivan, Judith L Linton, Matthew D. Ellington |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty Adolescent Knee Joint Physical examination Cerebral palsy Quadriceps Muscle 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Spastic cerebral palsy medicine Humans Orthopedics and Sports Medicine Postoperative Period Range of Motion Articular Child Gait Disorders Neurologic Retrospective Studies 030222 orthopedics medicine.diagnostic_test business.industry Cerebral Palsy Gross Motor Function Classification System General Medicine musculoskeletal system medicine.disease body regions Preferred walking speed Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Female Range of motion Cadence business human activities 030217 neurology & neurosurgery |
| Zdroj: | Journal of pediatric orthopedics. 38(4) |
| ISSN: | 1539-2570 |
| Popis: | Background Rectus femoris transfer (RFT) is used to treat stiff knee gait in spastic cerebral palsy. Recently, rectus femoris lengthening has been reported as treatment for stiff knee gait. The purpose of this study was to compare short-term outcomes of 2 surgical procedures. Methods A retrospective chart review of 23 patients (42 limbs) with diplegic spastic cerebral palsy who had undergone rectus femoris intramuscular lengthening for treatment of stiff knee gait with a Gross Motor Function Classification System level I, II, or III was completed. These patients were matched with a cohort of 23 patients (42 limbs) who had undergone RFTs based on age, sex, Gross Motor Function Classification System level, diagnosis, preoperative Gait Deviation Index, and any simultaneous surgeries. Preoperative and 1 year postoperative motion analysis data and physical examination were compared. Results There were no significant differences in demographics between the groups. On physical examination, a positive postoperative Duncan-Ely test was seen significantly less often in the transfer limbs (20 vs. 37). Average postoperative quad tone score was 1.56 for the transfer group compared with 2.19 for the lengthening group. No significant postoperative difference was seen between groups in stride length, walking speed, cadence, knee flexion at initial contact, peak knee flexion during loading response, mean knee flexion in stance, peak knee flexion in swing, time to peak knee flexion (% swing), time to peak knee flexion (% gait cycle), Gait Deviation Index or total knee range of motion. There was a difference in time to achieve 90 degrees passive knee flexion with the lengthening group reaching this in 8.3 days and transfer group in 15.3 days (P Conclusions Motion analysis parameters showed results of RFT and rectus femoris intramuscular lengthening to be equivalent 1 year postoperatively. Since rectus femoris lengthening is technically less difficult and rehabilitation faster, rectus femoris lengthening may be preferred if long-term follow-up supports these findings. Level of evidence Level III-retrospective comparative study. |
| Databáze: | OpenAIRE |
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