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Distal Femoral Shortening Osteotomy for Severe Knee Flexion Contracture and Crouch Gait in Cerebral Palsy

 Hoon Park  ;  Byoung Kyu Park  ;  Kun-Bo Park  ;  Sharkawy Wagih Abdel-Baki  ;  Isaac Rhee  ;  Chan Woo Kim  ;  Hyun Woo Kim 
 Journal of Clinical Medicine, Vol.8(9) : E1354, 2019 
Journal Title
 Journal of Clinical Medicine 
Issue Date
cerebral palsy ; crouch gait ; distal femoral shortening osteotomy ; patellar tendon advancement ; severe knee flexion contracture
Although there have been advancements of surgical techniques to correct gait abnormalities seen in patients with cerebral palsy, the crouch gait remains one of the most difficult problems to treat. The purpose of this retrospective study was to examine our results of distal femoral shortening osteotomy (DFSO) and patellar tendon advancement (PTA), performed in patients with crouch gait associated with severe knee flexion contracture. A total of 33 patients with a mean fixed knee contracture of 38° were included in the study. The mean age at the time of surgery was 12.2 years and the mean follow-up was 26.9 months. The measurements of clinical, radiological, and gait parameters were performed before and after surgery. The mean degrees of knee flexion contracture, Koshino index of patella height, and Gait Deviation Index were found to be significantly improved at the time of final follow-up. The maximum knee extension during the stance phase improved by an average of 25°, and the range of knee motion during gait increased postoperatively. On the other hand, the mean anterior pelvic tilt increased by 9.9°. Also, the maximum knee flexion during the swing phase decreased and the timing of peak knee flexion was observed to be delayed. We conclude that combined procedure of DFSO and PTA is an effective and safe surgical method for treating severe knee flexion contracture and crouch gait. However, the surgeons should be aware of the development of increased anterior pelvic tilt and stiff knee gait after the index operation.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyun Woo(김현우) ORCID logo https://orcid.org/0000-0001-8576-1877
Park, Kun Bo(박건보) ORCID logo https://orcid.org/0000-0002-8839-4870
Park, Hoon(박훈) ORCID logo https://orcid.org/0000-0002-8063-3742
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