| The relation of triceps surae surgical lengthening and crouch gait in patients with cerebral palsy. | |
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MedLine Citation:
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PMID: 20300011 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To investigate the effect of earlier triceps surae (TS) surgical lengthening at knee kinematics in the stance phase in patients with cerebral palsy (CP). One thousand and thirty-nine participants from an eligible total of 1750 children with CP were referred to gait analysis laboratory from January 2000 to April 2007. Inclusion criteria were the diagnosis of diparetic spastic CP levels I to III (GMFCS) and complete kinematics documentation. Patients with an asymmetrical knee pattern at kinematics and with different types of TS management among sides were excluded. The patients were divided into two groups according to the mean minimum knee flexion (MMKF) in stance phase: group A (n=253) MMKF > or =30 degrees and group B (n=786) MMKF less than 30 degrees . For each group, the occurrence of following procedures for TS in the past: (i) earlier surgery, (ii) gastrocnemius lengthening (zone I), (iii) gastrocnemius and soleus lengthening (zone II), and (iv) calcaneous tendon lengthening (zone III), was investigated. A chi test was applied to check if the number of procedures performed was different between groups. The level of significance was defined as P value of less than 0.05. The number of patients with no earlier surgeries at TS was higher in group B (51.8%) than in group A (39.1%), and this difference was significant (P<0.01). In addition, the number of procedures at the calcaneous tendon was more elevated in group A (36.8%) than in group B (27%), and this finding was statistically significant as well (P<0.02). The percentage of surgical lengthening at zones I and II was very similar between the groups A and B. This study has shown that patients without earlier surgical procedures at TS are more susceptible to reach better extension of the knees in the stance phase. Patients in a crouch gait had a higher number of calcaneous tendon lengthening performed in the past than patients with a more normal knee extension in the stance phase. |
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Authors:
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Mauro César de Morais Filho; Cátia Miyuki Kawamura; Paulo Rogério Cardozo Kanaji; Yara Juliano |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of pediatric orthopaedics. Part B Volume: 19 ISSN: 1473-5865 ISO Abbreviation: J Pediatr Orthop B Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-08 Completed Date: 2010-07-13 Revised Date: 2011-10-14 |
Medline Journal Info:
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Nlm Unique ID: 9300904 Medline TA: J Pediatr Orthop B Country: United States |
Other Details:
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Languages: eng Pagination: 226-30 Citation Subset: IM |
Affiliation:
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Association for the Care of Disabled Children (AACD), University of Santo Amaro, São Paulo, Brazil. mfmorais@terra.com.br |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Cerebral Palsy / physiopathology, surgery* Child Female Gait* Humans Knee Joint / physiopathology* Male Muscle, Skeletal / surgery* Retrospective Studies Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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