Abstract：
:Derotation osteotomies of the femur and tibia are established procedures to improve transverse plane deformities during walking with inwardly pointing knees and in- and out toeing gait. However, effects of femoral derotation osteotomies on gait were reported to be small, and those for the tibia are not known. Therefore, the aim of the study was to show the relation between the amount of intraoperative rotation and the changes during gait for osteotomies at femur and tibia levels, and predict those for the femur from preoperative clinical and gait data. Forty-four patients with spastic cerebral palsy between 6 and 19 years were included, 33 limbs received rotation only at the femur, 8 only at the tibia and 12 limbs at both levels. Gait analysis and clinical testing was performed pre- and 21.4 (SD=1.8) months postoperatively. The amount of intraoperative derotation of the femur showed no significant correlation with the change in hip rotation during walking (R=-0.17, p=0.25), whereas the rotation of the tibia showed an excellent relationship (R=0.84, p<0.001) with the change in knee rotation. Preoperative hip rotation during walking explained only 18% of the variability of the postoperative change in hip rotation during gait. Strength and passive range of motion in hip extension and abduction as well as hip extension or abduction or foot progression during walking did not show any predictive significance. In conclusion changes of knee rotation during gait is directly predictable from the amount of tibial corrections, contrary the change in hip rotation was not related to the amount of femoral derotation, and prediction was only fair.
journal_name
Gait Posturejournal_title
Gait & postureauthors
Böhm H,Hösl M,Dussa CU,Döderlein Ldoi
10.1016/j.gaitpost.2015.09.003subject
Has Abstractpub_date
2015-10-01 00:00:00pages
569-74issue
4eissn
0966-6362issn
1879-2219pii
S0966-6362(15)00851-6journal_volume
42pub_type
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