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Treatment of Hip and Knee Flexion Contracture in Spastic Cerebral Palsy

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Title: Treatment of Hip and Knee Flexion Contracture in Spastic Cerebral Palsy
Other Titles: 脳性麻痺股,膝関節屈曲拘縮に対する治療効果
Authors: Akiyama, Tomitaro / Kawaguchi, Yukiyoshi
Authors (alternative): 穐山, 富太郎 / 川口, 幸義
Issue Date: 31-Mar-1988
Citation: 長崎大学医療技術短期大学部紀要 = Bulletin of the School of Allied Medical Sciences, Nagasaki University. 1988, 1, p.3-18
Abstract: 歩行不能例を含めた脳性麻痺患者78例108肢の股,膝関節屈曲拘縮に対し,腸腰筋,ハムストリングを含めた屈筋群および他の軟部組織の解離,延長術を施行した. 手術目的は,屈曲拘縮の除去,屈筋共同収縮の抑制および伸筋群の機能強化により,股関節周囲筋のインバランスを改善し,股関節の求心性を改善すると同時に立位姿勢保持機能および移動能力を高めることにあった. 78例中55例71%に立位姿勢保持機能および移動能力に改善をみた.移動能力の改善には術後6カ月~2年間かかり,重度であればあるほど長期間を要した.B,C群において,手術の最もよい適応年齢は4~5歳であった.股関節亜脱臼例においてレ線上SF角,CE角,骨頭被覆率に明らかな改善を得た. / Soft tissue release operations to the hip and knee flexion contracture were performed on 108 extremities of 78 cerebral palsy patients including non-ambulatory cases. A successful operation requires accurate assessment of contracture and complete elimination of flexion contracture. Furthermore, postoperative physiotherapy is essential for having the patient detach from the preoperative pathological postural reaction mainly involving hyperactivities of the flexors and acquiring normal postural reaction to a possible extent primarily initiated by the extensors. The ability of locomotion was improved in 55 of 78 cases or in 71%. In severe cases, generalized hypertonia was alleviated. Improvement of the ability of locomotion after the operation required 6 months to 2 years in proportion to the severity of motor dysfunction. The most appropriate age for non-ambulatory groups (B and C groups) was 4 or 5 years. Roentgenograms generally disclosed definite improvement of sacro-femoral angle, and in subluxation cases, CE angle and covered ratio of the femoral head.
Keywords: Cerebral palsy / Lower leg / Flexion contracture / Hip subluxation / Operation
URI: http://hdl.handle.net/10069/18064
ISSN: 09160841
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 1

Citable URI : http://hdl.handle.net/10069/18064

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