Distal femoral osteotomy and patellar tendon advancement for the treatment of crouch gait in patients with bilateral spastic cerebral palsy.
Gait Posture
; 110: 53-58, 2024 05.
Article
en En
| MEDLINE
| ID: mdl-38492261
ABSTRACT
BACKGROUND:
Crouch gait, or flexed knee gait, represents a common gait pattern in patients with spastic bilateral cerebral palsy (CP). Distal femoral extension and/or shortening osteotomy (DFEO/DFSO) and patellar tendon advancement (PTA) can be considered as viable options when knee flexion contractures are involved. Better outcomes have been reported after a combination of both, independently of the presence of knee extensor lag. In this study, we evaluated the clinical and kinematic outcomes of these procedures. PATIENTS ANDMETHODS:
We reviewed a cohort of 52 limbs (28 patients) who were treated for crouch gait by DFEO/DFSO alone (group 1, n = 15) or DFEO/DFSO + PTA (group 2, n = 37) as a part of single event multilevel surgery (SEMLS). The mean age at surgery was 14 years, and the mean follow-up time was 18 months. The physical examination data and three-dimensional standardized gait analysis were collected and analyzed before the surgery and postoperatively.RESULTS:
Overall knee range of motion improved in all limbs. The knee flexion decreased significantly in both groups at initial, mid, and terminal stance. Hip flexion significantly decreased in mid-stance for limbs in group 2. Both clinical and gait parameters were most improved in limbs who underwent DFEO/DFSO + PTA. Increased pelvic tilt was observed in both groups after surgery.CONCLUSION:
Although DFEO/DFSO alone was successful in correcting knee flexion contractures, PTA has helped to improve knee extensor lag and knee extension during gait. LEVEL OF EVIDENCE Therapeutic level IV.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Osteotomía
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Parálisis Cerebral
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Rango del Movimiento Articular
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Ligamento Rotuliano
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Trastornos Neurológicos de la Marcha
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Fémur
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Articulación de la Rodilla
Límite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
Idioma:
En
Año:
2024
Tipo del documento:
Article