정형외과 수술 후 횡단면에서의 경직성 양지마비형 뇌성마비의 보행 변화

Abstract

Objective: The aim of this study was to evaluate the effect of orthopaedic surgery for correcting gait deviation on transverse plane with regard to the kinematic parameters in children with spastic diplegic cerebral palsy (CP). Method: Forty-one children with spastic diplegic CP were included. They were divided into 3 groups: femoral derotaional osteotomy (FDRO) group, multiple hip internal rotator lengthening (without FDRO) group and medial hamstring lengthening only group. Gait analysis was done before and at least 6 months after operation using Vicon 370 system (Oxford Metrics Ltd., Oxford, UK). Results: In FDRO group, average values of hip internal ro-tation and foot progression internal rotation were significantly improved (from 12.3o to 0.5o and from 6.5o to ⁣11.2o), but pelvic rotation was not changed. In another 2 groups without FDRO, there was no significant change in all kinematic parameters on transverse plane after surgery. Conclusion: In children with spastic diplegic CP, there were improvements in kinematic parameters of hip and foot on transverse plane after FDRO. However, the lengthening of medial hamstrings and other hip internal rotator muscles without FDRO had no significant effect on kinematic parameters on transverse plane.