title: Rectus femoris transfer to improve knee function of children with cerebral palsy.
abstract: Stance phase stability and swing phase clearance, prerequisites for normal ambulation, often are lost in the gait of children with cerebral palsy. Lengthening of the hamstrings usually will improve stance-phase knee extension but will not greatly alter swing-phase knee flexion. This paper presents the outcome of transfer of the distal end of the rectus femoris in conjunction with hamstrings lengthening in 37 knees, and compares it with a control group of 24 knees in which only hamstrings lengthening was done. In the first group swing-phase knee flexion was improved by 16.0 +/- 14.4 degrees, compared to 9.5 +/- 7.5 degrees in the control group, and residual knee flexion in stance was reduced to 8.9 +/- 8.1 degrees, compared to 15.1 +/- 13.8 degrees in the controls. Poor outcome in the transfer-plus-lengthening group was associated mainly with foot rotation in excess of 8 degrees internally or externally, or postoperative knee flexion in stance. Criteria for selection of cases and methods of improving surgical outcome are discussed.
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D003286:Contracture / Q000601:surgery*; D004576:Electromyography; D005260:Female; D005684:Gait; D006801:Humans; D007717:Knee / Q000601:surgery; D008297:Male; D009132:Muscles / Q000637:transplantation*; D011183:Postoperative Complications / Q000175:diagnosis