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首页> 外文期刊>Gait & posture >Long-term outcome of femoral derotation osteotomy in children with spastic diplegia
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Long-term outcome of femoral derotation osteotomy in children with spastic diplegia

机译：痉挛性截瘫患儿股骨移位截骨术的远期疗​​效

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Satisfactory short-term results after femoral derotation osteotomy (FDO) for the treatment of internal rotation gait in cerebral palsy have been reported by various authors. However, there are only a few longer-term studies reporting results 5. years after FDO and these are not in agreement. There are no reports on the clinical course beyond the pubertal growth spurt. 33 children with diplegia (n=. 59 legs, age: 10.5. ±. 3.6. years) and internally rotated gait were examined pre- (E0), 1. year (E1), 3. ±. 1 (E2) and 9. ±. 2 (E3). years after distal (27 legs) or proximal (32 legs) FDO as part of multilevel surgery, using standardized clinical exam and 3D gait-analysis at all examinations. The amount of intra-operative derotation averaged 25°. ANOVA was used for statistics (p<. 0.05). Mean hip internal rotation in stance at E0 of 17.3° was significantly changed to 1.0° of external rotation at E1 and was maintained at 4.2° at E3. The same clinical course was found for foot progression angle. The mid-point of passive hip rotation at E0 was 21°. This was significantly decreased to 6° at E1 and showed a small but significant increase reaching 12° at E3. The results of this study showed a good overall correction of internally rotated gait following FDO. These improvements were maintained at long-term follow-up after the pubertal growth spurt. Recurrence was observed in some cases with overall severe deterioration. In those patients persistent dynamic factors leading to recurrence should be further investigated.
机译：已有许多作者报道了股骨后旋截骨术（FDO）治疗脑瘫内旋步态后的短期满意结果。但是，只有少数较长期的研究报告了FDO 5年后的结果，但这些结果并不一致。除青春期生长骤增外，没有关于临床病程的报道。在（E0），1岁（E1），3。±之前检查了33名截瘫儿童（n =。59腿，年龄：10.5。±。3.6。岁），并且有内部旋转步态。 1（E2）和9。 2（E3）。远端（27条腿）或近端（32条腿）FDO作为多级手术的一部分后，在所有检查中均使用标准化的临床检查和3D步态分析。术中旋回量平均为25°。方差分析用于统计（p <0.05）。在E1为17.3°时，平均髋关节内部旋转姿势显着更改为E1处为1.0°外部旋转，而在E3处保持为4.2°。脚行进角发现了相同的临床过程。 E0处被动髋关节旋转的中点为21°。这在E1处显着降低至6°，在E3处显着升高，但达到12°。这项研究的结果表明，FDO后内部旋转步态得到了良好的整体矫正。这些改善在青春期生长骤增后的长期随访中得以保持。在某些情况下观察到复发，总体严重恶化。在那些患者中，导致复发的持续动态因素应进一步研究。

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