title: Predictive value of the Duncan-Ely test in distal rectus femoris transfer.
abstract: Fifty-six patients who underwent 94 distal rectus femoris transfers and pre- and postoperative gait analyses were retrospectively reviewed. The patients were divided into three groups based on pre- and postoperative Duncan-Ely tests. Group A (34 limbs) had positive tests both before and after surgery. Group B (46 limbs) had positive tests before surgery and negative tests after surgery. Group C (13 limbs) had negative tests both before and after surgery. One limb had a negative test before surgery and a positive test after surgery and was not included in any group. Knee arc increased significantly in both groups with positive preoperative Duncan-Ely tests (groups A and B), but not in the group with negative preoperative tests (group C). The timing of peak knee flexion in swing improved in all groups, but the change was smaller and not statistically significant in the group with negative preoperative tests (group C). The findings of the current study indicate that the Duncan-Ely test may be a helpful predictor of outcome in children for whom distal rectus femoris transfer is being considered. Caution should be exercised when patients have weak quadriceps and a negative Duncan-Ely test before surgery, particularly when concurrent calf lengthening procedures are planned.
authors.affiliation: Children's Orthopaedic Center, Children's Hospital Los Angeles and the Department of Orthopaedics, University of Southern California, Los Angeles, California 90027, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kay
authors.forename: Susan A
authors.initials: SA
authors.lastname: Rethlefsen
authors.forename: John P
authors.initials: JP
authors.lastname: Kelly
authors.forename: Tishya A L
authors.initials: TA
authors.lastname: Wren
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D004576:Electromyography; D005260:Female; D005684:Gait; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D009128:Muscle Spasticity / Q000601:surgery; D018482:Muscle, Skeletal / Q000503:physiopathology / Q000637:transplantation*; D016059:Range of Motion, Articular