Soft Tissue Surgery for Equinus Deformity in Spastic Hemiplegic Cerebral Palsy: Effects on Kinematic and Kinetic Parameters
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The purpose of this study was to evaluate how soft tissue surgery for correcting equinus deformity affects the kinematic and kinetic parameters of the ankle and proximal joints. Sixteen children with spastic hemiplegic cerebral palsy and equinus deformities (age range 3-16 years) were included. Soft tissue surgeries were performed exclusively on the ankle joint area in all subjects. Using computerized gait analysis (Vicon 370 Motion Analysis System), the kinematic and kinetic parameters during barefoot ambulation were collected preoperatively and postoperatively. In all 16 children, the abnormally increased ankle plantar flexion and pelvis anterior tilting on the sagittal plane were significantly improved without a weakening of push-off (p<0.05). In a group of 8 subjects with a recurvatum knee gait pattern before operation, the postoperative kinematic and kinetic parameters of the knee joint were significantly improved (p<0.05). In a group of 8 subjects with ipsilateral pelvic external rotation before operation, the postoperative pelvic deviations on the transverse plane were significantly decreased (p<0.05). These findings suggest that the soft tissue surgery for correcting equinus deformity improves not only the abnormal gait pattern of the ankle, but also that of the knee and pelvis.
Abstract
The purpose of this study was to evaluate how soft tissue surgery for correcting equinus deformity affects the kinematic and kinetic parameters of the ankle and proximal joints. Sixteen children with spastic hemiplegic cerebral palsy and equinus deformities (age range 3-16 years) were included. Soft tissue surgeries were performed exclusively on the ankle joint area in all subjects. Using computerized gait analysis (Vicon 370 Motion Analysis System), the kinematic and kinetic parameters during barefoot ambulation were collected preoperatively and postoperatively. In all 16 children, the abnormally increased ankle plantar flexion and pelvis anterior tilting on the sagittal plane were significantly improved without a weakening of push-off (p<0.05). In a group of 8 subjects with a recurvatum knee gait pattern before operation, the postoperative kinematic and kinetic parameters of the knee joint were significantly improved (p<0.05). In a group of 8 subjects with ipsilateral pelvic external rotation before operation, the postoperative pelvic deviations on the transverse plane were significantly decreased (p<0.05). These findings suggest that the soft tissue surgery for correcting equinus deformity improves not only the abnormal gait pattern of the ankle, but also that of the knee and pelvis.
참고문헌 (22)
- "Common gait abnormalities of the knee in cerebral palsy", pp.139~47
- "Sagittal gait patterns in spastic diplegia", 86, pp.251~258 (2004)
- "Complications in cerebral palsy treatment", pp.477~544 (1995), JB Lippincott Company
- "Spastic hemiplegic cerebral palsy and the femoral derotation osteotomy", 23, pp.314~320 (2003)
- "Gait patterns in spastic hemiplegia in children and young adults", j bone joint surg am 1987, pp.69~
- "Kinematic and kinetic evaluation of the ankle after lengthening of the gastrocnemius fascia in children with cerebral palsy", pp.727~32
- "Fixed and dynamic equinus in cerebral palsy: evaluation of ankle function after multilevel surgery", 21, pp.102~107 (2001)
- "Kinematic and kinetic evaluation of the ankle joint before and after tendo achilles lengthening in patients with spastic diplegia", 25, pp.479~483 (2005)
- "Ankle and knee coupling in patients with spastic diplegia: Effects of gastrocnemius- soleus lengthening", 84, pp.736~744 (2002)
- "Isolated calf lengthening in cerebral palsy", 83, pp.364~370 (2001)
- "Long- term follow-up of surgery for equinovarus foot deformity in children with cerebral palsy", 22, pp.792~799 (2002)
- "Surgical intervention in the correction of primary and secondary gait abnormalities", pp.359~85 (1991), Elsevier Science Publishers BV
- "The effects of botulinum toxin (BTX-A) on spasticity of the lower limb and on gait in cerebral palsy", 85, pp.943~948 (2003)
- "Secondary gait compensations in individuals without neuromuscular involvement following a unilateral imposed equinus constraint", 20, pp.238~244 (2004)
- "Gait analysis; Normal and pathological function", (rmal and pathological function) (1992), SLACK Incorporated
- "Common abnormal kinetic patterns of the knee in gait in spastic diplegia of cerebral palsy", 11, pp.224~232 (2000)
- "Gait analysis of the triceps surae in cerebral palsy", pp.511~20
- "A systematic approach to the amount of Achilles tendon lengthening in cerebral palsy", pp.448~51
- "Lengthening of the Achilles tendon in cerebral paresis Basic principles and follow- up study", pp.993~6
- "Multilevel orthopaedic surgery in group IV spastic hemiplegia", 87, pp.548~555 (2005)
- "Effect of derotation osteotomy of the femur on hip and pelvis rotations in hemiplegic and diplegic children", 11, pp.159~166 (2002)
- "Pelvic rotation during walking in children with spastic hemiplegia cerebral palsy", 7, pp.164~ (1998)
