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首页> 外文期刊>Gait & posture >Crouch gait changes after planovalgus foot deformity correction in ambulatory children with cerebral palsy
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Crouch gait changes after planovalgus foot deformity correction in ambulatory children with cerebral palsy

机译：行走性脑瘫患儿矫正扁平足后畸形的蹲伏步态

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Ambulatory children with cerebral palsy (CP) may present with several gait patterns due to muscular spasticity, commonly with crouch gait. Several factors may contribute to continuous knee flexion during gait, including hamstring and gastrocnemius contracture. In planovalgus foot deformity, the combination of heel equinus, talonavicular joint dislocation, midfoot break and external tibial torsion also contribute to crouch gait as part of lever arm dysfunction. In this retrospective cohort study, we assessed 21 children with CP (34 feet) who underwent planovalgus foot correction as a single level surgery. Fifteen feet underwent subtalar fusion and 19 feet had lateral calcaneal lengthening. Patients who underwent knee, hip or pelvis surgeries were excluded from the study. The aim was to examine the changes in gait pattern and the correlation between the changes of knee flexion at stance phase with the other kinematic and kinetic parameters after foot surgery. Post surgery change of Maximum knee extension at stance (MKE-dif) was the outcome of interest. The magnitude of change in MKE after surgery increased (less crouch after surgery) in patients who had milder preoperative planovalgus feet and higher preoperative ankle maximum dorsiflexion at stance and ankle power. The gain of knee extension after surgery correlated with correction of ankle hyperdorsiflexion and with increase of knee extension at initial contact and knee power. Patients with high preoperative ankle maximum dorsiflexion may benefit from surgical foot deformity correction to achieve decreased ankle dorsiflexion with no knee surgical intervention.
机译：患有脑瘫（CP）的非卧床儿童可能由于肌肉痉挛而表现出几种步态模式，通常表现为蹲伏式步态。多个因素可能会导致步态持续屈膝，包括绳肌和腓肠肌挛缩。在足扁平足畸形中，足跟部马蹄，足踝关节脱位，足中部折断和胫骨外扭转的组合也导致蹲伏步态，这是杠杆臂功能障碍的一部分。在这项回顾性队列研究中，我们评估了21例CP患儿（34英尺），他们接受了单侧手术矫正扁平乳头足。 15英尺行距骨下融合，19英尺行跟骨外侧加长。该研究排除了接受过膝，髋或骨盆手术的患者。目的是研究足部手术后步态的变化以及站立阶段膝部屈曲变化与其他运动学和动力学参数之间的相关性。感兴趣的结果是术后膝关节最大伸展姿势（MKE-dif）的改变。对于术前扁平足较轻的患者，术前踝关节最大背屈姿势和脚踝力量较高的患者，手术后MKE的变化幅度增加（术后蹲伏较少）。手术后膝盖伸展的增加与踝关节过度屈曲的矫正以及初始接触和膝盖力量时膝盖伸展的增加有关。术前踝最大背屈高的患者可通过手术足部畸形矫正来受益，而无需膝部手术干预即可实现踝背屈降低。

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