DISTAL RECTUS FEMORIS TRANSFER
DISTAL RECTUS FEMORIS TRANSFER
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远端股直肌转移
DOI：
10.1111/j.1469-8749.1987.tb02130.x
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发表时间：
1987
影响因子：
3.8
通讯作者：
J. Perry
中科院分区：
文献类型：
--
作者：
J. Perry
在脑瘫患儿的治疗中，一个主要的问题是由于其膝关节和髋关节的过度弯曲而导致的蹲姿。早些时候，我们关注髋屈曲，并认为股直肌作为股四头肌的一个活跃组成部分，造成了不必要的影响。建议手术近端解除直肌在髂骨上的附着。然而，45名脑瘫儿童的动态肌电记录显示，直肌在摇摆期更常见地活跃，这种方法只有在肌电图确认直肌在站立时发生功能时才适用。记录技术必须能够区分股直肌的活动和底层股肌的活动，这是表面电极无法做到的。以往的经验表明，常规的股直肌近端松解术（未证实该肌肉的活动仅限于站立）会导致患者出现腿僵硬的步态。因此股直肌的活动需要更密切的关注。
A major concern in the management of children with cerebral palsy is crouch gait with its excessively flexed knee and hip stance. Earlier, attention was given to the flexed hip and it was assumed that the rectus femoris, as an active component of the quadriceps, contributed an unwanted effect. Proximal surgical release of the rectus from its attachment on the ilium was recommended. However, dynamic electromyographic records of 45 children with cerebral palsy demonstrated that the rectus more commonly was active in the swing phase, and such an approach is appropriate only when electromyography confirms that rectus function is occurring in stance. The recording technique must be capable of differentiating rectus femoris action from that of the underlying vasti, which surface electrodes are not able to do. Past experience indicates that routine inclusion of a proximal rectus femoris release (without confirmation that the muscle's action was limited to stance) resulted in the patient having a stiff‐legged gait. Hence the actions of the rectus femoris need closer attention.