Psoas release at the pelvic brim in ambulatory patients with cerebral palsy: Operative technique and functional outcome
Psoas release at the pelvic brim in ambulatory patients with cerebral palsy: Operative technique and functional outcome
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DOI：
10.1097/00004694-199709000-00002
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发表时间：
1997-09-01
影响因子：
1.7
通讯作者：
Chambers, HG
中科院分区：
文献类型：
--
作者：
Sutherland, DH;Zilberfarb, JL;Chambers, HG
17例(29个髋部)脑性瘫痪患者接受了骨盆边缘腰大肌后退手术。手术技术是股鞘外侧的直接前入路。没有感染，也没有神经或动脉损伤。术后临床检查显示，所有患者的固定性髋屈肌挛缩症均明显减少。所有受试者都保留了在重力和手动阻力下弯曲臀部的能力。所有受试者都接受了术前和术后的步态分析。站姿时动态最小髋关节屈曲显著降低。对于年龄较小的儿童，动态骨盆倾斜度改善到了统计上显着的水平，但对整个组来说并没有改善。随着年龄的增长，改善较少。所有患者的步长均显著增加，节律显著降低。我们认为，对于骨盆前倾角过大、动力髋屈或屈臀痉挛过大的脑性瘫痪患儿，采用股鞘外侧前入路骨盆缘腰大肌后退是一种安全、可靠、有效的手术方法。
Seventeen patients with cerebral palsy (29 hips) underwent psoas recession at the pelvic brim. The operative technique was a direct anterior approach, lateral to the femoral sheath. Then were no infections or nerve or arterial injuries. After surgery, clinical examination revealed that fixed hip-flexion contractures decreased significantly in all patients. All of the subjects retained the ability to flex the hip against gravity and against manual resistance. All of the subjects underwent pre-and postoperative gait analysis. Stance-phase dynamic minimum hip flexion decreased significantly. Dynamic pelvic tilt improved to a statistically significant level for the younger children but did not for the group as a whole. There was less improvement with increasing age. Step length was significantly increased and cadence significantly decreased in all patients. We conclude that psoas recession at the pelvic brim, by using the anterior approach, lateral to the femoral sheath, is a safe, reliable, and effective procedure for children with cerebral palsy who have excessive anterior pelvic tilt and excessive dynamic hip flexion or hip-flexion contracture.