脑瘫患儿内侧腘绳肌延长术后步态分析  

Assessment of gait analysis in patients with diplegic cerebral palsy after medial hamstring lengthening.

作　　者：徐宏文[1] 马瑞雪[2] 吉士俊[3] 

机构地区：[1]广州儿童医院骨科,510120 [2]上海复旦大学附属儿科医院骨科,200032 [3]中国医科大学附属第二医院,沈阳市110004

出　　处：《临床小儿外科杂志》2009年第3期17-21,共5页Journal of Clinical Pediatric Surgery

摘　　要：目的利用计算机辅助的定量步态分析技术，评价内侧腘绳肌延长术对双侧痉挛性脑瘫步态的影响。方法将双侧痉挛性脑瘫患儿分为两组，一组为髂腰肌组，采取内侧腘绳肌延长，股直肌远端转位加髂腰肌延长术。另一组为非髂腰肌组，采取内侧腘绳肌延长，股直肌远端转位术。利用计算机辅助的定量步态分析技术．对两组患儿术前和术后运动学、动力学数据进行比较分析。结果髂腰肌组术后骨盆前倾角度明显增大，髋关节屈曲度增加，并出现膝反屈倾向。结论①髂腰肌组术后出现“腘绳肌功能不全”模型，即骨盆过度前倾、髋关节屈怕度增加和膝反屈倾向。②腘窝角的测量结果不能作为腘绳肌延长术的唯一指征。③股直肌远端转位术可改善蹲伏步态患儿膝关节在摆动期的增大屈膝角度，使足有较大的自由活动空间。④计算机辅助的定量步态分析可对复杂的病理步态进行全面、客观、动态的描述。Objective To evaluate the effects of medial hamstring lengthening on gait analysis in patients with diplegie cerebral palsy. Methods A group of patients who underwent medial hamstring lengthening and distal rectus transfer was compared to a group of patient who underwent intramuscular psoas lengthening as well by computer instrumented quantitative gait analysis. Results Patient who underwent a psaos lengthening showed an increased anterior pelvic tilt and a tendency towards genu recurvatum,features that eouht in- dicate postoperative hamstring weakness. Conclusions The results underline the importance of medial hamstrings for pelvis and knee motion in the sagittal plane during walking.In additional the limitations of the popliteal angle as a clinical measure to evaluate hamstring length in the presenee of hip flexor tightness are discussed.

关 键 词：脑性瘫痪/外科学 步态 

分 类 号：R318.01[医药卫生—生物医学工程] R726.821.7[医药卫生—基础医学]