title: Medial hamstring lengthening in the presence of hip flexor tightness in spastic diplegia.
abstract: This study evaluated the effects of medial hamstring lengthening on gait in patients with diplegic cerebral palsy. A group of patients who underwent medial hamstring lengthening and distal rectus transfer was compared to a group of patients who underwent intramuscular psoas lengthening as well. Patients who underwent a psoas lengthening showed an increased anterior pelvic tilt and a tendency towards genu recurvatum, features that could indicate postoperative hamstring weakness. These results underline the importance of medial hamstrings for pelvis and knee motion in the sagittal plane during walking. In additional the limitations of the popliteal angle as a clinical measure to evaluate hamstring length in the presence of hip flexor tightness are discussed.
authors.affiliation: Paediatric Orthopaedic Unit, Department of Paediatric Surgery, Karl Franzens University, Auenbruggerplatz 34, A-8036 Graz, Austria. ernst.zwick@kfunigraz.ac.at
authors.forename: Ernst B
authors.initials: EB
authors.lastname: Zwick
authors.forename: Vinay
authors.initials: V
authors.lastname: Saraph
authors.forename: Gertrude
authors.initials: G
authors.lastname: Zwick
authors.forename: Christiane
authors.initials: C
authors.lastname: Steinwender
authors.forename: Wolfgang E
authors.initials: WE
authors.lastname: Linhart
authors.forename: Gerhardt
authors.initials: G
authors.lastname: Steinwender
mesh_terms: D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D005684:Gait; D006801:Humans; D007700:Kinetics; D018482:Muscle, Skeletal / Q000601:surgery*; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D016896:Treatment Outcome