Gait & Posture
Volume 30, Issue 4 , Pages 487-491 , November 2009

Effects of distal hamstring lengthening on sagittal motion in patients with diplegia: Hamstring length and its clinical use

  • Moon Seok Park

      Affiliations

    • Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Sungnam, Kyungki 463-707, Republic of Korea
    • ,
  • Chin Youb Chung

      Affiliations

    • Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Sungnam, Kyungki 463-707, Republic of Korea
    • ,
  • Sang Hyeong Lee

      Affiliations

    • Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Sungnam, Kyungki 463-707, Republic of Korea
    • ,
  • In Ho Choi

      Affiliations

    • Department of Orthopedic Surgery, Seoul National University Children's Hospital, 28 Yongun-Dong, Chongro-Gu, Seoul 110-744, Republic of Korea
    • ,
  • Tae-Joon Cho

      Affiliations

    • Department of Orthopedic Surgery, Seoul National University Children's Hospital, 28 Yongun-Dong, Chongro-Gu, Seoul 110-744, Republic of Korea
    • ,
  • Won Joon Yoo

      Affiliations

    • Department of Orthopedic Surgery, Seoul National University Children's Hospital, 28 Yongun-Dong, Chongro-Gu, Seoul 110-744, Republic of Korea
    • ,
  • B.S. Myoung Yl Park

      Affiliations

    • Motion Analysis Korea, 642-1 Yeoksam-Dong, Kangnam-Gu, Seoul 135-080, Republic of Korea
    • ,
  • Kyoung Min Lee

      Affiliations

    • Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Sungnam, Kyungki 463-707, Republic of Korea
    • Corresponding Author InformationCorresponding author. Tel.: +82 31 787 6256; fax: +82 31 787 4056.

Received 29 November 2008 ,Revised 1 July 2009 ,Accepted 14 July 2009.

References 

  1. Gage JR, Perry J, Hicks RR, Koop S, Werntz JR. Rectus femoris transfer to improve knee function of children with cerebral palsy. Dev Med Child Neurol. 1987;29:159–166
  2. Thometz J, Simon S, Rosenthal R. The effect on gait of lengthening of the medial hamstrings in cerebral palsy. J Bone Joint Surg Am. 1989;71:345–353
  3. DeLuca PA, Ounpuu S, Davis RB, Walsh JH. Effect of hamstring and psoas lengthening on pelvic tilt in patients with spastic diplegic cerebral palsy. J Pediatr Orthop. 1998;18:712–718
  4. Saraph V, Zwick EB, Zwick G, Steinwender C, Steinwender G, Linhart W. Multilevel surgery in spastic diplegia: evaluation by physical examination and gait analysis in 25 children. J Pediatr Orthop. 2002;22:150–157
  5. Chang WN, Tsirikos AI, Miller F, Lennon N, Schuyler J, Kerstetter L, et al. Distal hamstring lengthening in ambulatory children with cerebral palsy: primary versus revision procedures. Gait Posture. 2004;19:298–304
  6. Adolfsen SE, Ounpuu S, Bell KJ, DeLuca PA. Kinematic and kinetic outcomes after identical multilevel soft tissue surgery in children with cerebral palsy. J Pediatr Orthop. 2007;27:658–667
  7. Rethlefsen S, Tolo VT, Reynolds RA, Kay R. Outcome of hamstring lengthening and distal rectus femoris transfer surgery. J Pediatr Orthop. 1999;8:75–79
  8. Gage JR. Surgical treatment of knee dysfunction in cerebral palsy. Clin Orthop Relat Res. 1990;45–54
  9. Gage J. The treatment of gait problems in cerebral palsy. London: Mac Keith Press. p. 364–66.
  10. Zwick E, Saraph V, Zwick G, Steinwender C, Linhart W, Steinwender G. Medial hamstring lengthening in the presence of hip flexor tightness in spastic diplegia. Gait Posture. 2002;16:288–296
  11. Schutte LM, Hayden SW, Gage JR. Lengths of hamstrings and psoas muscles during crouch gait: effects of femoral anteversion. J Orthop Res. 1997;15:615–621
  12. Delp SL, Arnold AS, Speers RA, Moore CA. Hamstrings and psoas lengths during normal and crouch gait: implications for muscle-tendon surgery. J Orthop Res. 1996;14:144–151
  13. Hoffinger SA, Rab GT, Abou-Ghaida H. Hamstrings in cerebral palsy crouch gait. J Pediatr Orthop. 1993;13:722–726
  14. Arnold AS, Liu MQ, Schwartz MH, Ounpuu S, Dias LS, Delp SL. Do the hamstrings operate at increased muscle-tendon lengths and velocities after surgical lengthening?. J Biomech. 2006;39:1498–1506
  15. Arnold AS, Blemker SS, Delp SL. Evaluation of a deformable musculoskeletal model for estimating muscle-tendon lengths during crouch gait. Ann Biomed Eng. 2001;29:263–274
  16. Rodda JM, Graham HK, Carson L, Galea MP, Wolfe R. Sagittal gait patterns in spastic diplegia. J Bone Joint Surg Br. 2004;86(2):251–258
  17. Chung CY, Stout J, Gage JR. Rectus femoris transfer-gracilis versus sartorius. Gait Posture. 1997;6:137–146
  18. Delp SL, Loan JP, Hoy MG, Zajac FE, Topp EL, Rosen JM. An interactive graphics-based model of the lower extremity to study orthopaedic surgical procedures. IEEE Trans Biomed Eng. 1990;37:757–767
  19. Lofterod B, Terjesen T. Local and distant effects of isolated calf muscle lengthening in children with cerebral palsy and equinus gait. J Child Orthop. 2008;2:55–61
  20. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed.. Hillsdale, NJ: Lawrence Earlbaum Associates; 1988;
  21. Stout JL, Gage JR, Schwartz MH, Novacheck TF. Distal femoral extension osteotomy and patellar tendon advancement to treat persistent crouch gait in cerebral palsy. J Bone Joint Surg Am. 2008;90:2470–2484
  22. Klatt J, Stevens PM. Guided growth for fixed knee flexion deformity. J Pediatr Orthop. 2008;28:626–631
  23. Gough M, Eve LC, Robinson RO, Shortland AP. Short-term outcome of multilevel surgical intervention in spastic diplegic cerebral palsy compared with the natural history. Dev Med Child Neurol. 2004;46:91–97
  24. Gordon AB, Baird GO, McMulkin ML, Caskey PM, Ferguson RL. Gait analysis outcomes of percutaneous medial hamstring tenotomies in children with cerebral palsy. J Pediatr Orthop. 2008;28:324–329
  25. Thompson NS, Baker RJ, Cosgrove AP, Corry IS, Graham HK. Musculoskeletal modelling in determining the effect of botulinum toxin on the hamstrings of patients with crouch gait. Dev Med Child Neurol. 1998;40:622–625
  26. Thompson NS, Baker RJ, Cosgrove AP, Saunders JL, Taylor TC. Relevance of the popliteal angle to hamstring length in cerebral palsy crouch gait. J Pediatr Orthop. 2001;21:383–387

☆ This study was conducted at Seoul National University Bundang Hospital.

PII: S0966-6362(09)00309-9

doi: 10.1016/j.gaitpost.2009.07.115

Gait & Posture
Volume 30, Issue 4 , Pages 487-491 , November 2009

Article Tools

* Image Usage & Resolution